Author(s)

Gong Qiang ¹

Affiliation(s)

¹ Department of Cardiology, Baoding NO.1 Central Hospital, Baoding, 071000, China

Corresponding Author

Gong Qiang

ABSTRACT

This observational study aimed to evaluate the diagnostic value of coronary computed tomography angiography (CCTA) and CT-derived fractional flow reserve (CT-FFR) in assessing lesion-specific ischemia. A total of 116 patients with suspected coronary artery disease (CAD) admitted between June 2023 and February 2025 underwent CCTA and CT-FFR, with invasive coronary angiography (ICA) combined with FFR as the reference standard. A total of 348 coronary segments were analyzed, and ICA-FFR confirmed 82 ischemic lesions (23.56%). The diagnostic performance of CCTA showed a sensitivity of 75.61% (62/82), specificity of 81.36% (214/266), and accuracy of 80.46% (276/343), while CT-FFR demonstrated a sensitivity of 84.15% (69/82), specificity of 89.08% (237/266), and accuracy of 87.76% (306/349). When CCTA stenosis ≥50% was combined with CT-FFR ≤0.80, diagnostic performance improved significantly, achieving a sensitivity of 89.02% (73/82), specificity of 92.48% (246/266), and accuracy of 91.40% (319/349) (all P<0.05 compared with standalone methods). Stratified analysis revealed that CT-FFR outperformed CCTA in identifying ischemia in the left anterior descending artery (AUC=0.912 vs. 0.825) and right coronary artery (AUC=0.887 vs. 0.813, P<0.05), while both methods showed comparable efficacy in left main and circumflex lesions. These findings suggest that combining CCTA with CT-FFR significantly enhances the diagnostic accuracy for lesion-specific ischemia, particularly in the left anterior descending and right coronary arteries, providing a noninvasive and efficient tool for individualized management of CAD. 

KEYWORDS

Coronary Artery Disease, Computed Tomography Angiography, Fractional Flow Reserve, Lesion-Specific Ischemia, Diagnostic Efficacy

CITE THIS PAPER

Gong Qiang, Observational Study on the Value of CCTA and CT-FFR in Assessing Coronary Lesion-Specific Ischemia. MEDS Clinical Medicine (2025) Vol. 6: 120-126. DOI: http://dx.doi.org/10.23977/medsc.2025.060319.

REFERENCES

[1] Cao Hongyan, Cai Xiaohang, Sun Guocheng. Value of CCTA and CT-FFR in evaluating lesion-specific myocardial ischemia. Chinese Journal of CT and MRI 2023; 21(5):52-54.
[2] Wang Rui, Ouyang LiNa, Wu Qian, Niu Yuanyuan, Li Guilan, Zhu Li. Predictive value of CT-derived fractional flow reserve for major adverse cardiovascular events in patients with obstructive coronary artery disease. Chinese General Practice 2025;28(6):713-719.
[3] Liu QianGgui, Wang Kun, Xie Li, Lai Li, Chen Jinhong. Comparative study of coronary CCTA versus combined CCTA and CT-FFR using Siemens dual-source 64-slice CT. China Science and Technology Journal Database (Medicine) 2022(10):55-57.
[4] Li Zhuo, Zhang Lei. Clinical value of CT angiography and coronary stenosis severity in evaluating lesion-specific ischemia. Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease 2021;19(22):4012-4016.
[5] Xu HaiJia, He Wei, Guo WeiFeng, Yang Shan, Dou Yehong, Lu Haifeng. Diagnostic value of plaque characteristic index based on coronary CT angiography for lesion-specific myocardial ischemia in patients with stable coronary artery disease. Chinese Journal of Clinical Medicine 2024;31(2):200-207.
[6] Han Han. Comparative study of two imaging modalities in evaluating coronary artery stenosis in middle-aged and elderly patients. Journal of Imaging Research and Medical Applications 2020;4(24):83-85.
[7] Fan Gang, Li Bo, Dong Li, Zhang Linfeng. Comparative study of intravascular ultrasound versus 64-slice spiral CT coronary angiography in qualitative and quantitative evaluation of coronary calcified lesions. Chinese Journal of CT and MRI 2021;19(1):90-92.
[8] Zhang JiaQi, Liu Xin, Zhao WeiDong, Zhang Zhijing, Yin Hongmei, Zhang Yinghui, Xu Yasha, Lv Jiewen. Clinical study using intravascular ultrasound to evaluate the accuracy of 64-slice spiral CT in assessing coronary borderline lesions and plaque characteristics. Chinese Medical Journal of Metallurgical Industry 2008;25(4):387-388.

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