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September 26, 2012

Detecting Obstructive Coronary Disease With CT Angiography and Noninvasive Fractional Flow Reserve

Author Affiliations

Author Affiliation: Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina.

JAMA. 2012;308(12):1269-1270. doi:10.1001/2012.jama.11383

Physicians commonly encounter patients reporting chest discomfort. In these cases, the physician needs to determine whether the patient has obstructive coronary artery disease (CAD), and if so, whether the patient is at increased risk of future cardiovascular events. The ultimate goal of this evaluation is to direct optimal medical therapy and potentially lead to ischemia-driven coronary revascularization. The fractional flow reserve (FFR) performed during invasive coronary angiography has been shown to provide lesion-specific data on ischemia, which, when used to direct revascularization, leads to improved clinical outcomes.1,2 Fractional flow reserve is the ratio of the mean coronary artery pressure distal to an obstructive coronary lesion relative to the mean aortic pressure during maximal coronary blood flow and represents a physiologic measure of coronary stenosis.