Illinois: According to a study, patients with stable angina who have high coronary artery calcium scores can be identified using an enhanced CT scan at a lower risk of experiencing negative outcomes in three years.
The findings of the study were published in Radiology, a journal of the Radiological Society of North America (RSNA).
Researchers from Denmark conducted a prospective study to evaluate the three-year clinical outcomes of patients who underwent CT angiography and the fractional flow reserve (CT-FFR) that was produced from the CT angiography. CT-FFR simulates the amount of blood flowing through the coronary arteries using pictures from coronary CT angiography of the heart, AI algorithms, and computational fluid dynamics.
“CT angiography is the first step in identifying the presence of coronary artery disease, but it doesn’t show the impact on blood flow in the arteries,” said lead researcher Kristian T. Madsen, M.D., and Ph.D. candidate in the Department of Cardiology at the University Hospital of Southern Denmark in Esbjerg. “Turbulent blood flow may create abnormal pressure in the vessel that grinds down coronary plaques making them prone to rupture.”
Non-contrast enhanced cardiac CT is typically performed prior to CT angiography to determine the amount of coronary artery calcium, which is a surrogate marker for total coronary plaque, a fatty buildup in the arteries, that can lead to a future heart attack. A coronary artery calcium score of 400 or higher indicates high plaque levels. As calcium absorbs a lot of x-rays, it can be especially challenging to assess coronary CT images of patients with high amounts of coronary artery calcium.
The study group included patients with new onset stable coronary artery disease consecutively enrolled in the Assessing Diagnostic Value of Non-Invasive CT-FFR in Coronary Care (ADVANCE) clinical trial between December 2015 and October 2017 at three Danish sites. Eligibility factors for the trial included at least one coronary artery stenosis, or narrowing, greater than 30% and no atrial fibrillation (irregular heartbeat) or prior coronary revascularization, which is a procedure or surgery that improves blood flow to the heart.
