Authors
Yanchun Chen, Wenjing Jia, Xiaoyu Ma, Yifeng Gao, Zhen Zhou, Lei Xu
Published in
Journal of cardiovascular development and disease. Volume 13. Issue 9. Sep 15, 2026. Epub Sep 15, 2026.
Abstract
Background: Interpretation of intermediate computed tomography-derived fractional flow reserve (CT-FFR) remains uncertain. We evaluated whether Coronary Artery Disease Reporting and Data System (CAD-RADS) severity modifies the association between CT-FFR and downstream management in patients with CT-FFR 0.71-0.80. Methods: This retrospective study included 973 symptomatic patients stratified by index-vessel CAD-RADS category and CT-FFR 0.71-0.75 versus 0.76-0.80. Planned revascularization within 90 days was the primary outcome. Multivariable logistic regression assessed CT-FFR associations and interaction with CAD-RADS; major adverse cardiac and cerebrovascular events (MACCE) were exploratory. Results: Planned revascularization occurred in 39.8% versus 19.3% of patients with CT-FFR 0.71-0.75 versus 0.76-0.80 (adjusted odds ratio [OR], 2.38; 95% confidence interval [CI], 1.72-3.29; p < 0.001). Each 0.01 decrease in CT-FFR was associated with higher odds of revascularization (adjusted OR, 1.23; 95% CI, 1.15-1.32; p < 0.001). The association differed by CAD-RADS category (interaction p = 0.011), with a more pronounced association observed in CAD-RADS 3 (adjusted OR per 0.01 decrease, 1.39; 95% CI, 1.25-1.54). During a median follow-up of 384 days, 31 patients (3.2%) experienced MACCE, with no significant adjusted association with CT-FFR. Conclusions: Among patients with intermediate CT-FFR, lower values were associated with a higher likelihood of planned revascularization, and the magnitude of this association differed across CAD-RADS categories.
PMID:
42783072
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.
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