(Press-News.org) Munich, Germany – Data presented today from the prospective Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography (DeFACTO) study show that, when compared to standard coronary angiography (CT), the non-invasive assessment of fractional flow reserve by computed tomography (FFRct) provides a more accurate determination of which lesions require invasive evaluation.(1)
The results of the study were presented by Dr James K. Min, director of Cardiac Imaging Research and co-director of Cardiac Imaging at the Department of Medicine, Imaging and Biomedical Sciences at Cedars-Sinai Heart Institute in Los Angeles, USA.
The study compared the ability of FFRct and CT alone to identify flow-restricting lesions by assessment of fractional flow reserve, a measurement recognised as the gold standard for determining which lesions require treatment.(2) DeFACTO enrolled 252 stable patients with suspected coronary artery disease at 17 centres in five countries. All patients underwent CT, invasive coronary angiography, invasive FFR and subsequent FFRct analysis.
Results showed that FFRct was better able to identify flow-restricting arterial lesions than CT alone. The per-patient sensitivity and specificity of FFRct were also higher than CT alone using an area under the curve (AUC) analysis (AUC 0.81 vs. 0.68, p=0.0002).
The improvement in diagnostic performance was found greatest in arterial blockages of intermediate severity. In this set of patients, there was over a two-fold increase in test sensitivity, from 37 to 82%, with no loss of specificity. In these patients, the AUC improved from 0.53 for CT alone to 0.80 for FFRct (p=0.0002).
"One of the central challenges in taking care of patients with coronary artery disease is knowing which ones need further invasive evaluation for determining the need for coronary revascularization," said Dr Min. "The results of the DeFACTO trial clearly demonstrate that when added to coronary CT angiographic findings, FFRct provides essential physiologic information as to which specific arterial blockages truly restrict blood flow to the heart and heighten patient risk.
"This is an exciting step forward for cardiology that could significantly improve how we guide patients towards the most effective and efficient care. Our findings also suggest that FFRct could be particularly useful for evaluating patients with arterial blockages of an intermediate severity, which are often the most difficult to assess non-invasively. This represents a large group of patients who unfortunately are often prone to frequent misdiagnosis.
"In addition, given the high negative predictive value of FFRct, it may serve as an effective 'gatekeeper' to further unnecessary invasive procedures."
###
References
1. The HeartFlow technology investigated in the study is a web-based service that enables the computation of non-invasive fractional flow reserve and thereby the identification of which lesions are causing ischemia. The technology computes FFRct from patient-specific 3D computational models of the aorta, heart and coronary artery tree obtained from CT scan data and results are transmitted via HeartFlow's secure web interface as an interactive report
2. Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS); European Association for Percutaneous Cardiovascular Interventions (EAPCI). Guidelines on Myocardial Revascularization. Eur Heart J 2010; 31: 2501-255.
Notes to editors
Please note that the author's photo and CV as well as the spokesperson's CV can be found here
About the European Society of Cardiology www.escardio.org
The European Society of Cardiology (ESC) represents more than 75,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2012
The ESC Congress is currently the world's premier conference on the science, management and prevention of cardiovascular disease. ESC Congress 2012 takes place 25-29 August at the Messe München in Munich. The scientific programme is available at: http://spo.escardio.org/Welcome.aspx?eevtid=54
More information is available from the ESC Press Office at press@escardio.org.
The DeFACTO study
Non-invasive fractional flow reserve in the identification of flow-restricting arterial blockage in patients with suspected coronary artery disease
2012-08-27
ELSE PRESS RELEASES FROM THIS DATE:
Median follow-up results from the ALTITUDE study, stopped prematurely in December 2011
2012-08-27
Munich, Germany – Preliminary results from the Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE) do not support administration of aliskiren on top of standard therapy with renin-angiotensin-aldosterone system (RAAS) blockade in type 2 diabetics at high risk of cardiovascular and renal events, according to Professor Hans-Henrik Parving from Rigshospitalet, University of Copenhagen, Denmark. Presenting results from the study today, he said the treatment "may even be harmful".
The ALTITUDE trial was stopped prematurely in December 2011 on recommendation ...
The TRILOGY ACS study
2012-08-27
Munich, Germany – The first trial to study the effect of platelet inhibition in patients with acute coronary syndromes managed medically without revascularisation has found no significant difference between prasugrel and clopidogrel in the prevention of death, myocardial infarction or stroke.
The findings, from the phase III Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) study, were presented today at a Hot Line session of ESC Congress 2012 in Munich.
TRILOGY ACS was double-blind, randomised trial ...
The PARAMOUNT study
2012-08-27
Munich, Germany – The novel angiotensin receptor neprilysin inhibitor, LCZ696, demonstrated beneficial effects in heart failure patients with preserved ejection fraction (HFpEF), according to results of the PARAMOUNT (Prospective compArison of ARNI with ARB on Management Of heart failUre with preserved ejectioN fracTion) trial.
Approximately half of all heart failure patients have normal or nearly normal ejection fraction, a measure of their strength of cardiac contraction. However, while many studies have shown a benefit of pharmacological therapies in heart failure ...
The Aldo-DHF study
2012-08-27
Munich, Germany – Mineralocorticoid receptor antagonists should be considered as a treatment option in hypertensive patients with diastolic heart failure, said Professor Burkert Pieske presenting results today of the Aldosterone Receptor Blockade in Diastolic Heart Failure (Aldo-DHF) study at ESC Congress 2012.
Behind his conclusion lay results showing that mineralocorticoid receptor blockade with spironolactone improves cardiac function and structure, reduces neuroendocrine activation, and effectively reduces blood pressure in a patient population with symptomatic predominantly ...
Obesity triggers AF in fertile women
2012-08-27
Munich, Germany – Obesity triggers atrial fibrillation in fertile women, according to research presented today at the ESC Congress 2012 by Dr Deniz Karasoy from Denmark.
Atrial fibrillation and obesity are among the largest public health related challenges in the western world today. Atrial fibrillation is the commonest heart rhythm disorder and is associated with increased mortality and morbidity. Previous studies have demonstrated that obesity increases the risk of new-onset atrial fibrillation in individuals with known risk factors for developing atrial fibrillation ...
Female gender increases stroke risk in AF patients aged over 75 years by 20%
2012-08-27
Munich, Germany – Female gender increases the risk of stroke in patients with atrial fibrillation (AF) aged >75 years by 20%, according to a study presented today at the ESC Congress 2012. The findings were presented by Anders Mikkelsen, from Denmark.
The results suggest that female gender should not be included as an independent stroke/thromboembolism (TE) risk factor in guidelines or risk stratification schemes used in treatment of patients with atrial fibrillation.
The increased risk of stroke and TE in patients with atrial fibrillation depends on additional risk ...
Women with acute heart failure have similar in-hospital mortality to men but are less treated
2012-08-27
Munich, Germany – Women with acute heart failure have similar in-hospital mortality to men but are less treated in the real world, according to results from the global ALARM-HF registry presented today at the ESC Congress 2012. The findings were presented by Dr John T. Parissis from Greece.
Acute heart failure (AHF) is a frequent clinical situation with high short- and long-term mortality as well as high hospitalization rates. The Acute Heart Failure Global Registry of Standard Treatment (ALARM-HF) is an in-hospital chart audit survey which includes patients hospitalized ...
Drug eluting stents used less often in women than men
2012-08-27
Munich, Germany – Drug eluting stents (DES) are used less often in women treated with percutaneous coronary intervention (PCI) for coronary artery disease than men treated with PCI for the same condition, according to research presented today, August 25, at the ESC Congress 2012. The findings from a country-wide Germany registry were presented by Dr Martin Russ.
Coronary artery disease is still a leading cause of mortality and morbidity in Europe and worldwide. During treatment with PCI, cardiologists can use bare metal stents (BMS) or the newer DES. While they do not ...
Passive smoking increases platelet activation in healthy people
2012-08-27
"It is well known that passive smoking is harmful for cardiovascular health, but the mechanism has not yet been discovered," said Dr Kaya. "We investigated the effects of passive smoking on the levels of three parameters – mean platelet volume (MPV), carboxyhemoglobin (COHb) and lactate - in an effort to further understand this mechanism. We also looked at the correlation between the three parameters."
Mean platelet volume (MPV) is a well established indicator of platelet activation that is increased in acute thrombotic events. It is suspected that carbon monoxide (CO) ...
Continuous spinal cord stimulation improves heart function
2012-08-27
Munich, Germany – Spinal cord stimulation improves heart function and could become a novel treatment option for heart failure, according to research presented at the ESC Congress 2012 today, August 25, by Professor Hung-Fat Tse from Hong Kong.
Heart failure is a progressive weakening of the heart muscle. It is a chronic condition that occurs when the heart cannot pump blood to meet the body's needs. When heart failure is present, not enough blood is circulating, which may cause fatigue. Further, fluid accumulation in the abdomen and legs and congestion in the lungs is ...
LAST 30 PRESS RELEASES:
The Lancet: Tens of thousands of children aged under five suffering acute malnutrition in Gaza, recent estimates suggest
Prostate testing may not target those most likely to benefit, warn experts
Global analysis shows hidden damage from men’s alcohol use
DRI recognizes Ashley Cornish as the 2025 Peter B. Wagner Memorial Award Winner for Women in Atmospheric Sciences
Unlocking the blueprint for a powerful plant-based drug
Bringing modern science to vitamin biology: Isha Jain wins NIH Transformative Research Award
University of Houston scientists learn that rare bacterium ‘plays dead’ to survive
Introduced animals change how island plants spread, new global study finds
Mayo Clinic researchers discover ‘traffic controller’ protein that protects DNA, and may help kill cancer cells
Protein sidekick exhibits dual roles in stress granule assembly and disassembly
New hope for MS
Kennesaw State professor receives grant to study cancer origins
Pain and antidepressant drug combo linked to increased seizure risk in older adults
Cancer researchers shape new strategies for immunotherapy
Physical exercise can ‘train’ the immune system
Calm red brocket deer can learn to "Come" and other commands - but the flightiest, most restless individuals struggle
China, the world's largest tea producer, is predicted to experience increases in land suitable for tea-growing under climate change, with the overall range shifting northwards, per AI modeling study
Composing crews for Mars missions
Early humans butchered elephants using small tools and made big tools from their bones
1,000-year-old gut microbiome revealed for young man who lived in pre-Hispanic Mexico
Bears and pandas in captivity develop significantly different gut microbiomes compared to their wild counterparts, and giant pandas in particular have less diverse microbiomes than their wild counterp
Prenatal and postnatal support apps might not work
Dancing dust devils trace raging winds on Mars
Raging winds on Mars
Real-time biopsies uncover hidden response to glioblastoma therapy
Repeated brain tumor sampling uncovers treatment response in patients with glioblastoma
Novel immunotherapy combination destroys colorectal liver metastases
Farmed totoaba could curb poaching
Avalanches: user-carried safety device increases survival time fivefold
It’s all in your head: Select neurons in the brainstem may hold the key to treating chronic pain
[Press-News.org] The DeFACTO studyNon-invasive fractional flow reserve in the identification of flow-restricting arterial blockage in patients with suspected coronary artery disease