ArticleEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology2025
Usefulness of FFR-CT to exclude haemodynamically significant lesions in high-risk NSTE-ACS.
Article in EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
ECG-less Coronary Computed Tomography Angiography in the Management of Patients Presenting With High-troponin Chest Pain
Diagnostic Accuracy of ECG-less Gated Cardiac CT in Resuscitated Cardiac Arrest Survivors
Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- From Electrocardiography to the Catheterization Laboratory: A Multimodal Artificial Intelligence Framework for Acute Coronary Syndrome Detection and Risk Stratification.Diagnostics (Basel, Switzerland) · 2026Review
- FFR-CT: Technical Advances and Implementation in Clinical Practice.Journal of imaging · 2026Review
- Deep Learning and Cardiovascular Diseases: An Updated Narrative Review.Journal of clinical medicine · 2026Review
- Advances in Diagnosis and Therapeutic Guidance for Acute Coronary Syndrome: A Narrative of A Precision Medicine Approach.Reviews in cardiovascular medicine · 2026Review
- AI-Driven multi-view learning from CCTA for myocardial infarction diagnosis.The international journal of cardiovascular imaging · 2026Article
- Digital twins and simulations in transcatheter coronary and structural heart interventions.European heart journal. Digital health · 2026Review
- Coronary CT Angiography for PCI Planning and Guidance: A Comprehensive Narrative Review.Medicina (Kaunas, Lithuania) · 2026Review
- Clinical Impact of CT-Based FFR in Everyday Cardiology: Bridging Computation and Decision-Making.Biomedicines · 2025Review
- Myocardial Infarction with Obstructive, Non-Obstructive, and Mimicking Conditions: Clinical Phenotypes, Diagnostic Imaging, Management, and Prognosis.Journal of clinical medicine · 2025Article
- Avoiding invasive angiography in non-ST-elevation MI patients: are coronary CT angiography and FFR-CT the answer?EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Article
Corrections and comments
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Authors and funding
16 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary computed tomography angiography (CCTA) and fractional flow reserve (FFR) derived from CCTA (FFR-CT) may provide a means of reducing unnecessary invasive coronary angiography (ICA) in patients with suspected non-ST-elevation acute coronary syndromes (NSTE-ACS).
aimsThe aim of this study was to evaluate the capacity of FFR-CT and CCTA to rule out significant lesions in high-risk NSTE-ACS patients, using ICA with invasive FFR as the gold standard.
methodsHigh-risk NSTE-ACS patients admitted to 4 European centres were enrolled in this single-arm, prospective core lab-adjudicated study. Patients underwent CCTA with FFR-CT analysis, followed by ICA with invasive FFR.
resultsOut of the 250 initially planned NSTE-ACS patients, 168 were included, of whom 151 (92%) had sufficient CCTA image quality to undergo CCTA and FFR-CT analysis. The median high-sensitivity troponin T level at 1 hour post-hospitalisation was 5.3 (interquartile range: 1.8-18.6) times the upper reference limit. At the patient level, the diagnostic performance of FFR-CT was numerically higher as compared to CCTA though not statistically significant (sensitivity: 94% vs 93%, specificity: 63% vs 54%, positive predictive value: 83% vs 79%, negative predictive value: 85% vs 80% and accuracy: 83% vs 79%; p=0.58), suggesting an enhanced capability to avoid unnecessary ICA. At the lesion level, the ability of FFR-CT to detect significant lesions was significantly better than that of CCTA (receiver operating characteristic curves: 0.84 vs 0.65 respectively; p<0.01).
conclusionsIn patients with high-risk NSTE-ACS, FFR-CT offers better diagnostic accuracy - though not statistically significant - and a higher ability to rule out haemodynamically significant stenoses as compared to CCTA. This indicates that FFR-CT can reduce unnecessary invasive procedures by more accurately identifying patients requiring further intervention.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.