Coronary Artery Disease Clinical Trial
Official title:
Computed Tomography Derived Fractional Flow Reserve for Coronary Hemodynamic Ischemia Noninvasive Assessment (CT-FFR-CHINA)
Computed Tomography Derived Fractional Flow Reserve (CT-FFR) is a noninvasive method for evaluating the hemodynamic significance of coronary artery lesions by using coronary CT Angiography (CCTA) as opposed to invasive FFR examination under invasive coronary angiography. The purpose of the CT-FFR-CHINA study is to verify that the diagnostic performance of hemodynamically significant lesions by CT-FFR is superior than routine anatomic evaluation of diameter stenosis using CCTA alone using invasive FFR as the reference standard, exclusively in Chinese population.
Numerous studies have demonstrated high diagnostic accuracy of CCTA to detect and exclude
coronary artery disease (CAD). One main limitation of CCTA, however, is a tendency to
overestimate the severity of coronary artery stenosis against invasive coronary angiography
(ICA). On the other hand, FFR, invasively measured under ICA, is recognized as the current
gold standard in determination of coronary artery lesions due to improved long-term clinical
outcomes when revascularization is guided by FFR instead of ICA. Moreover, prior studies
indicated unreliable relationships between detection of obstructive anatomic coronary artery
stenoses defined by CCTA and hemodynamically significant lesions by invasive fractional flow
reserve (FFR).
Recent advances in artificial intelligence and computational modeling techniques now permit
construction of a 3-dimensional model of coronary arteries visible from CCTA images and
computation of FFR anywhere in the entire 3D model noninvasively. Several prior prospective,
multicenter studies have reported promising results for the diagnostic performance of CT-FFR
using invasive FFR as the reference standard. However, the diagnostic performance of CT-FFR
in Chinese population is not clear. Therefore, we hereby designed the CT-FFR-CHINA study to
determine the hemodynamically significant lesions, exclusively in Chinese subjects. It is a
prospective and multi-center trial with a total of 326 subjects enrolled at 4 Chinese
centers.
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