Coronary disease & ACSRandomised controlled trial

Addition of Computed Tomography–Derived Fractional Flow Reserve in the Diagnostic Pathway of Patients With Stable Coronary Artery Disease

J Am Coll CardiolPublished

  • Randomised controlled trial
  • investigator-initiated
  • multicentre

Authors' conclusion

Adding FFRct to the diagnostic pathway of patients with a 50% to 90% stenosis on CCTA reduced the rate of ICA without obstructive CAD at 90 days and 1 year, without differences in revascularizations, quality of life, and costs compared with usual care.

Study context

Population
Stable coronary artery disease (CAD) patients with 50% to 90% stenosis in ≥1 coronary artery on coronary computed tomography angiography (CCTA)
Participants
528 patients
Comparison
FFRct-guided vs usual care
  • FFRctn = 263
  • Usual caren = 265reference
Primary endpoint
ICA without obstructive CAD
Follow-up
90 days

Primary result

As reported in the abstract

Odds ratio

0.46

95% CI 0.31–0.69

P < 0.001

Events by treatment group

FFRct-guided vs Usual care
OR 0.46 (95% CI 0.31–0.69); P < 0.001

Secondary outcomes

ICA use (post hoc exploratory) · 90 days · post hoc exploratory endpoint

P = 0.004

OutcomeP value
Revascularization · 1 yearP = 0.948

Invasive coronary angiography (ICA) without obstructive CAD and ICA use · 1 year

Both differences persisted at 1 year

Quality of life, costs, MACE

Did not differ between groups; clinical event rates low

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Addition of Computed Tomography–Derived Fractional Flow Reserve in the Diagnostic Pathway of Patients With Stable Coronary Artery Disease. J Am Coll Cardiol. Published 28 August 2026. doi:10.1016/j.jacc.2026.08.036

Summarised from the published abstract; every number is checked against it