A 2-year investigation of the impact of the computed tomography-derived fractional flow reserve calculated using a deep learning algorithm on routine decision-making for coronary artery disease management.
Eur Radiol
; 31(9): 7039-7046, 2021 Sep.
Article
en En
| MEDLINE
| ID: mdl-33630159
ABSTRACT
OBJECTIVE:
This study aims to investigate the safety and feasibility of using a deep learning algorithm to calculate computed tomography angiography-based fractional flow reserve (DL-FFRCT) as an alternative to invasive coronary angiography (ICA) in the selection of patients for coronary intervention. MATERIALS ANDMETHODS:
Patients (N = 296) with symptomatic coronary artery disease identified by coronary computed tomography angiography (CTA) with stenosis over 50% were retrospectively enrolled from a single centre in this study. ICA-guided interventions were performed in patients at admission, and DL-FFRCT was conducted retrospectively. The influences on decision-making by using DL-FFRCT and the clinical outcome were compared to those of ICA-guided care for symptomatic CAD at the 2-year follow-up evaluation.RESULT:
Two hundred forty-three patients were evaluated. Up to 72% of diagnostic ICA studies could have been avoided by using a DL-FFRCT value > 0.8 as a cut-off for intervention. A similar major adverse cardiovascular event (MACE) rate was observed in patients who underwent revascularisation with a DL-FFRCT value ≤ 0.8 (2.9%) compared to that of ICA-guided interventions (3.3%) (stented lesions with ICA stenosis > 75%) (p = 0.838).CONCLUSION:
DL-FFRCT can reduce the need for diagnostic coronary angiography when identifying patients suitable for coronary intervention. A low MACE rate was found in a 2-year follow-up investigation. KEY POINTS ⢠Seventy-two percent of diagnostic ICA studies could have been avoided by using a DL-FFRCT value > 0.8 as a cut-off for intervention. ⢠Coronary artery stenting based on the diagnosis by using a 320-detector row CT scanner and a positive DL-FFRCT value could potentially be associated with a lower occurrence rate of major adverse cardiovascular events (2.9%) within the first 2 years. ⢠A low event rate was found when intervention was performed in tandem lesions with haemodynamic significance based on DL-FFRCT < 0.8 as a cut-off value.Palabras clave
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Estenosis Coronaria
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Reserva del Flujo Fraccional Miocárdico
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Aprendizaje Profundo
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Eur Radiol
Asunto de la revista:
RADIOLOGIA
Año:
2021
Tipo del documento:
Article
País de afiliación:
China