The findings back several clinical trial conclusions that the use of FFRCT accurately reflects invasively-measured FFR. They also plug in gaps in understanding the clinical outcomes derived from the use of coronary CTA and FFRCT to determine treatment, an area that lacks much information.

"Surprisingly we found that some patients with a positive test result Who were not referred to cath for various reasons had a six-fold increased risk of myocardial infarction when compared to those with a positive test result who were sent to the cath lab," said Nørgaard. "We need to see that our findings can be mirrored in other centers and health care systems through multicenter prospective studies. We also need to learn more in future studies on how to best interpret a positive CT-FFR result, and how to best manage such patients."


Such multicenter prospective studies are ongoing, one of which is a large multinational, clinical practice CT-FFR registry of 5,000 patients. Data from this trial is set to be published in early 2019. Large scale randomized trials investigating the prognostic value of CT-FFR against conventional ischemia testing like SPECT and stress echo are also in pipeline.

Data for this study was supplied by the Western Denmark Cardiac Computed Tomography (WDCT) Registry, the Danish National Patient Registry, and the Civil Registration System.

The findings were published in the Journal of the American College of Cardiology.

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