Global trans-lesional computed tomography-derived fractional flow reserve gradient is associated with clinical outcomes in diabetic patients with non-obstructive coronary artery disease
Main finding · MACEResult — go to the resultHazard ratio 2.86 95% CI 1.75–4.68Authors' conclusion
In diabetic patients with non-obstructive CAD, GΔCT-FFR was associated with clinical outcomes at 5 year follow-up, which illuminates a novel and feasible approach to improved risk stratification for a global hemodynamic assessment of coronary artery in diabetic patients.
Study context
- Population
- Patients with diabetes suspected of having coronary artery disease (CAD); mean age 60.1 ± 10.3 years, 53.7% male
- Participants
- 1,215 patients
- Exposure
- High vs low global trans-lesional CT-FFR gradient (GΔCT-FFR) without flow-limiting stenosis
- Outcome
- MACE
- Follow-up
- Median 57.3 months
Methodological detailsprospective enrolment
- Prospective enrolment
Main finding
As reported in the abstract
Hazard ratio
2.86
95% CI 1.75–4.68
P < 0.001
High-gradient without flow-limitingvs Low-gradient without flow-limiting
HR 2.86 (95% CI 1.75–4.68); P < 0.001
- Major adverse cardiovascular events (MACE) incidence, overall
- 11.3%
- GΔCT-FFR, independent risk factor of MACE in multivariable analysis: HR
- 2.88 (95% CI 1.76-4.70, P < 0.001)
Observational data: associations, not effects.
Further findings
Incremental prognostic value of GΔCT-FFR among 4 risk models
- Model 4 (incl. GΔCT-FFR) highest C-statistic (P = 0.002)
- 0.75
- Net reclassification improvement (NRI) of model 4 beyond model 3 (P < 0.001)
- 0.605
Original publication
Global trans-lesional computed tomography-derived fractional flow reserve gradient is associated with clinical outcomes in diabetic patients with non-obstructive coronary artery disease. Cardiovasc Diabetol. Published 26 July 2023. doi:10.
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