The value of CT-QFR combined with CCTA in predicting percutaneous coronary intervention for patients with severe calcification and chest Pain as well as the diagnostic efficacy of CT-QFR
LIU Xiaoxue
GU Hui
YU Xinxin
WANG Ximing
Abstract：Objective This study was designed to determine whether the strategy of adding CT derived quantitative flow ratio(CT-QFR)to anatomicalcoronary CT angiography(CCTA)for invasive coronary angiography(ICA)referral better predicted per-cutaneous coronary intervention(PCI)in patients with severe calcified chest pain and the diagnostic consistency between posi-tive CT-QFR and positive ICA.Methods This retrospective study included 85 patients with chest pain with severe calcification who were referred to ICA after CCTA.The primary endpoint was the predictive value of positive CT-QFR combined with positive CCTA for PCI.The secondary endpoint was to assess diagnostic consistency between positive CT-QFR(CT-QFR≤0.80)and posi-tive ICA(≥70%stenosis of the three main stems).Results This study included a total of 85 patients(255 vessels).The CT-QFR<0.80 group comprised 132 vessels(52%),while the CT-QFR≥0.80 group included 123 vessels(48%).CCTA revealed severe stenosis in 116 vessels(45%),and ICA indicated severe stenosis(≥70%stenosis)in 150 vessels(59%).CT-QFR was inconsistent with severe stenosis of CCTA by 40%(102/255)and with ICA by 33%(84/255).71%(49/69)of the vessels receiv-ing PCI were CT-QFR positive.CT-QFR positive,CCTA positive and ICA positive all had high predictive value for PCI(AUC=0.63,0.66,0.71,P<0.05),while the combined predictive value of CT-QFR positive and CCTA positive was significantly in-creased(AUC=0.71),which was comparable to the predictive value of ICA positive.Conclusions In the diagnostic and treat-ment strategy for patients with severe calcified chest pain,the combination of CT-QFR and CCTA can more accurately predict the need for PCI,and CT-QFR demonstrates a high diagnostic consistency with ICA.
Keywords：Quantitative flow ratioCoronary artery computed tomography angiographyInvasive coronary angiographyCoronary artery disease
Publication Date：2025-04-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 30-34 )