woman_heart_2Using an analysis platform from HeartFlow Inc, Redwood City, Calif, to assess a standard coronary CT angiogram (cCTA) may change the course of treatment for a significant number of patients with coronary artery disease, according to a recent study.

Presented by Nick Curzen, professor at the University Hospital Southampton, United Kingdom, at the EuroPCR 2015 conference, results of the FFRCT RIPCORD study reinforced the ability of the HeartFlow Analysis to aid in patient management.

The HeartFlow Analysis is a non-invasive imaging technology for coronary artery disease that offers physicians insight on both the extent of any arterial blockage, as well its impact on blood flow. Using standard cCTA images, HeartFlow’s technology solves millions of complex equations simulating blood flow in the coronary arteries to provide mathematically computed fractional flow reserve (FFRCT) values.

During the study, cardiologists reviewed cCTAs of 200 consecutive cases of patients with stable chest pain and agreed on one of three treatment options: optimal medical therapy, a percutaneous coronary intervention (PCI) such as a stent, or coronary bypass surgery. In some cases, physicians agreed that they were unable to make a decision and needed more information, such as an invasive diagnostic angiogram with associated invasive fractional flow reserve (FFR).

Physicians were then shown the results of the HeartFlow FFRCT Analysis for each case and made a second management decision incorporating these data. Adding the HeartFlow Analysis changed the decision to medical therapy in 26 of the 87 cases (30 percent) initially recommended for a PCI. Of cases originally recommended for medical therapy, 7 of 67 (9 percent) were changed to PCI and one was changed to bypass surgery. Without the HeartFlow Analysis, the physicians needed more information in 38 cases (19 percent), but with the HeartFlow Analysis, there were no cases in which the physicians needed additional information.

Overall, the management plan was changed in 72 of the 200 patients (36 percent). In 16 of the 87 cases considered candidates for PCI based on the angiogram (18 percent), one or more of the target lesions was changed using the FFRCT Analysis.

“It is well established that invasive FFR can refine management decisions based solely upon the angiogram for patients with chest pain,” Curzen said. “This study demonstrates that the non-invasive HeartFlow FFRCT Analysis has the potential to become the default method for the initial assessment of many patients with cardiac-sounding chest pain by assessing both the coronary anatomy and physiology simultaneously. This could have important implications for our clinical practice and would challenge conventional care pathways.”

For more information, visit HeartFlow.

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