Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4)
Authors' conclusion
The addition of vFFR to ICA changed intended management strategy in 22% of patients, provided a detailed and specific 'all-in-one' anatomical and physiological assessment of coronary artery disease, and was accompanied by augmentation of the operator's confidence in the treatment strategy.
Study context
- Population
- All-comers undergoing invasive coronary angiogram (ICA) for NSTEMI acute coronary syndrome (ACS) or chronic coronary syndrome, North of England208 ACS, 112 chronic coronary syndrome (CCS)
- Participants
- 320 participants
- Exposure
- Management plan after ICA vs after vFFR disclosure
- Outcome
- Change in intended management after vFFR disclosure (hypothesis >10%)
Methodological detailsmulticentre, 5 hospitals
- Multicentre
- 5 hospitals
Main finding
As reported in the abstract
Change in intended management
Change in intended management after vFFR disclosure, all patients
22%
ACS: increase in number planned for medical management
62%
CCS: increase in number planned for percutaneous coronary intervention (PCI)
31%
Observational data: associations, not effects.
Further findings
Physician confidence (of 10)
P < 0.001
| Outcome | ICA | vFFR | P value |
|---|---|---|---|
| Significantly stenosed vessels per patient | mean 1.16 ± 0.96 | mean 1.18 ± 0.92 | P = 0.79 |
- vFFR value
- 0.82 · median · range as printed 0.70–0.91
Original publication
Modelled impact of virtual fractional flow reserve in patients undergoing coronary angiography (VIRTU-4). Heart. Published 16 May 2024. doi:10.
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