Journal of Clinical Medicine (Jul 2020)
Sequential Strategy Including FFR<sub>CT</sub> Plus Stress-CTP Impacts on Management of Patients with Stable Chest Pain: The Stress-CTP RIPCORD Study
- Andrea Baggiano,
- Laura Fusini,
- Alberico Del Torto,
- Patrizia Vivona,
- Marco Guglielmo,
- Giuseppe Muscogiuri,
- Margherita Soldi,
- Chiara Martini,
- Enrico Fraschini,
- Mark G. Rabbat,
- Francesca Baessato,
- Gloria Cicala,
- Maria L. Danza,
- Annachiara Cavaliere,
- Antonella Loffreno,
- Vitanio Palmisano,
- Francesca Ricci,
- Giulia Rizzon,
- Elisabetta Tonet,
- Giacomo M. Viani,
- Saima Mushtaq,
- Edoardo Conte,
- Andrea D. Annoni,
- Alberto Formenti,
- Maria E. Mancini,
- Franco Fabbiocchi,
- Piero Montorsi,
- Daniela Trabattoni,
- Alexia Rossi,
- Fabio Fazzari,
- Nicola Gaibazzi,
- Daniele Andreini,
- Emilio M. Assanelli,
- Antonio L. Bartorelli,
- Mauro Pepi,
- Andrea I. Guaricci,
- Gianluca Pontone
Affiliations
- Andrea Baggiano
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Laura Fusini
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Alberico Del Torto
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Patrizia Vivona
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Marco Guglielmo
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Giuseppe Muscogiuri
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Margherita Soldi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Chiara Martini
- Department of Radiology, Azienda Ospedaliero-Universitaria, 43126 Parma, Italy
- Enrico Fraschini
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Mark G. Rabbat
- Loyola University Medical Center, Center for Heart & Vascular Medicine, Maywood, IL 60153, USA
- Francesca Baessato
- Divisione di Cardiologia, Dipartimento di Medicina, Università degli Studi, 37134 Verona, Italy
- Gloria Cicala
- Dipartimento di Medicina e Chirurgia, Azienda Ospedaliero-Universitaria di Parma, Università degli Studi, 43126 Parma, Italy
- Maria L. Danza
- Division of Cardiology, University of Rome Tor Vergata, 00133 Rome, Italy
- Annachiara Cavaliere
- Dipartimento di Medicina, Istituto di Radiologia, Università degli Studi, 35128 Padova, Italy
- Antonella Loffreno
- U.O.C. Cardiologia 1, Ospedale di Circolo e Fondazione Macchi, Università degli Studi, 21100 Varese, Italy
- Vitanio Palmisano
- Diagnostica per Immagini, Università degli Studi di Cagliari, Monserrato, 09042 Cagliari, Italy
- Francesca Ricci
- Department of Biomedicine and Prevention Division of Diagnostic Imaging University of Rome Tor Vergata, 00133 Rome, Italy
- Giulia Rizzon
- Dipartimento di Medicina, Istituto di Radiologia, Università degli Studi, 35128 Padova, Italy
- Elisabetta Tonet
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Cona, 44124 Ferrara, Italy
- Giacomo M. Viani
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Saima Mushtaq
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Edoardo Conte
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Andrea D. Annoni
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Alberto Formenti
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Maria E. Mancini
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Franco Fabbiocchi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Piero Montorsi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Daniela Trabattoni
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Alexia Rossi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20090 Milan, Italy
- Fabio Fazzari
- Department of Diagnostic Imaging, Humanitas Research Hospital, Rozzano, 20089 Milan, Italy
- Nicola Gaibazzi
- Unità Operativa di Cardiologia, Azienda Ospedaliero-Universitaria di Parma, Università degli Studi, 43126 Parma, Italy
- Daniele Andreini
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Emilio M. Assanelli
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Antonio L. Bartorelli
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Mauro Pepi
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- Andrea I. Guaricci
- Institute of Cardiovascular Disease, Department of Emergency and Organ Transplantation, University Hospital Policlinico of Bari, 70124 Bari, Italy
- Gianluca Pontone
- Centro Cardiologico Monzino IRCCS, 20138 Milan, Italy
- DOI
- https://doi.org/10.3390/jcm9072147
- Journal volume & issue
-
Vol. 9,
no. 7
p. 2147
Abstract
Stress computed tomography perfusion (Stress-CTP) and computed tomography-derived fractional flow reserve (FFRCT) are functional techniques that can be added to coronary computed tomography angiography (cCTA) to improve the management of patients with suspected coronary artery disease (CAD). This retrospective analysis from the PERFECTION study aims to assess the impact of their availability on the management of patients with suspected CAD scheduled for invasive coronary angiography (ICA) and invasive FFR. The management plan was defined as optimal medical therapy (OMT) or revascularization and was recorded for the following strategies: cCTA alone, cCTA+FFRCT, cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP. In 291 prospectively enrolled patients, cCTA+FFRCT, cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP showed a similar rate of reclassification of cCTA findings when FFRCT and Stress-CTP were added to cCTA. cCTA, cCTA+FFRCT, cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP showed a rate of agreement versus the final therapeutic decision of 63%, 71%, 89%, 84% (cCTA+Stress-CTP and cCTA+FFRCT+Stress-CTP vs cCTA and cCTA+FFRCT: p CT+Stress-CTP vs cCTA and cCTA+FFRCT: p CT and Stress-CTP improved therapeutic decision-making compared to cCTA alone, and a sequential strategy with cCTA+FFRCT+Stress-CTP represents the best compromise in terms of clinical impact and radiation exposure.
Keywords
- clinical management
- computed tomography
- coronary artery disease
- fractional flow reserve
- myocardial perfusion