Eurointervention最新文献

{"title":"Development and validation of the D-PACE scoring system to predict delayed high-grade conduction disturbances after transcatheter aortic valve implantation.","authors":"Francesco Bendandi, Nevio Taglieri, Leonardo Ciurlanti, Alessandro Mazzapicchi, Marco Foroni, Laura Lombardi, Francesco Palermo, Francesco Filice, Gabriele Ghetti, Antonio Giulio Bruno, Mateusz Orzalkiewicz, Giuliano Costa, Valentina Frittitta, Alessandro Comis, Sofia Sammartino, Maria Chiara Calì, Elena Dipietro, Luigi La Rosa, Corrado Tamburino, Tullio Palmerini, Marco Barbanti, Francesco Saia","doi":"10.4244/EIJ-D-24-00850","DOIUrl":"10.4244/EIJ-D-24-00850","url":null,"abstract":"<p><strong>Background: </strong>New conduction disturbances are frequent after transcatheter aortic valve implantation (TAVI). Refining our ability to predict high-grade atrioventricular block (AVB) occurring later than 24 hours after the procedure would be useful in order to select patients eligible for early discharge.</p><p><strong>Aims: </strong>This study was designed to identify predictors of high-grade AVB occurring between 24 hours and 30 days after TAVI and to develop and validate a predictive risk score.</p><p><strong>Methods: </strong>We analysed clinical, procedural, and electrocardiographic parameters of 1,290 TAVI patients. Independent predictors of delayed high-grade AVB were used to develop the predictive score, which was then externally validated in a cohort of 936 patients.</p><p><strong>Results: </strong>Implantation of self-expanding valves, greater implantation depth, longer PR interval in preprocedural electrocardiogram (ECG) and greater increase of PR duration in next-day ECG, preprocedural right bundle branch block (RBBB) and new-onset left bundle branch block or RBBB that persisted in next-day ECG were independent predictors of delayed high-grade AVB and were combined to develop the Delayed atrioventricular block Prediction for eArly disChargE (D-PACE) score. The areas under the curve of the score were 0.879 (95% confidence interval [CI]: 0.835-0.923) and 0.799 (95% CI: 0.730-0.868) in the derivation and validation cohorts, respectively. Based on the score, patients can be classified into three risk categories; low-risk patients demonstrated an incidence of delayed AVB of less than 1% and are ideal candidates for next-day discharge.</p><p><strong>Conclusions: </strong>The D-PACE score can be used to stratify TAVI patients according to their risk of delayed high-grade AVB and thereby identify those suitable for next-day discharge.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e119-e129"},"PeriodicalIF":7.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early outcomes of the novel Myval THV series compared to SAPIEN THV series and Evolut THV series in individuals with severe aortic stenosis.","authors":"Niels van Royen, Ignacio J Amat-Santos, Martin Hudec, Matjaz Bunc, Alexander Ijsselmuiden, Peep Laanmets, Daniel Unic, Béla Merkely, Renicus S Hermanides, Vlasis Ninios, Marcin Protasiewicz, Benno J W M Rensing, Pedro L Martin, Fausto Feres, Manuel De Sousa, Eric Van Belle, Axel Linke, Alfonso Ielasi, Matteo Montorfano, Mark Webster, Konstantinos Toutouzas, Emmanuel Teiger, Francesco Bedogni, Michiel Voskuil, Manuel Pan, Oskar Angerås, Won-Keun Kim, Jürgen Rothe, Ivica Kristić, Vicente Peral, Ben J L Van den Branden, Dirk Westermann, Barbara Bellini, Mario Garcia-Gomez, Akihiro Tobe, Tsung-Ying Tsai, Scot Garg, Ashokkumar Thakkar, Udita Chandra, Marie-Claude Morice, Osama Soliman, Yoshinobu Onuma, Patrick W Serruys, Andreas Baumbach","doi":"10.4244/EIJ-D-24-00951","DOIUrl":"10.4244/EIJ-D-24-00951","url":null,"abstract":"<p><strong>Background: </strong>There are limited head-to-head randomised trials comparing the performance of different transcatheter heart valves (THVs).</p><p><strong>Aims: </strong>We aimed to evaluate the non-inferiority of the balloon-expandable Myval THV series compared to the balloon-expandable SAPIEN THV series or the self-expanding Evolut THV series.</p><p><strong>Methods: </strong>The LANDMARK trial randomised 768 patients in a 1:1 ratio, (Myval THV series [n=384] vs contemporary series with 50% SAPIEN THV series [n=192] and 50% Evolut THV series [n=192]). The non-inferiority of Myval over the SAPIEN or Evolut THV series in terms of the 30-day primary composite safety and effectiveness endpoint as per the third Valve Academic Research Consortium (VARC-3) was tested in an intention-to-treat population with a predefined statistical power of 80% (1-sided alpha of 5%) for a non-inferiority margin of 10.44%.</p><p><strong>Results: </strong>The Myval THV series achieved non-inferiority for the primary composite endpoint over the SAPIEN THV series (24.7% vs 24.1%, risk difference [95% confidence interval {CI}]: 0.6% [not applicable {NA} to 8.0]; p=0.0033) and the Evolut THV series (24.7% vs 30.0%, risk difference [95% CI]: -5.3% [NA to 2.5]; p<0.0001). The incidences of pacemaker implantation were comparable (Myval THV series: 15.0%, SAPIEN THV series: 17.3%, Evolut THV series: 16.8%). At 30 days, the mean pressure gradient and effective orifice area were significantly better with the Myval THV series compared to the SAPIEN THV series (p<0.0001) and better with the Evolut THV series than with the Myval THV series (p<0.0001). At 30 days, the proportion of moderate to severe prosthetic valve regurgitation was numerically higher with the Evolut THV series compared to the Myval THV series (7.4% vs 3.4%; p=0.06), while not significantly different between the Myval THV series and the SAPIEN THV series (3.4% vs 1.6%; p=0.32).</p><p><strong>Conclusions: </strong>The Myval THV series is non-inferior to the SAPIEN THV series and the Evolut THV series in terms of the primary composite endpoint at 30 days.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov: NCT04275726; EudraCT number 2020-000,137-40.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"e105-e118"},"PeriodicalIF":7.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729642/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenge of early discharge after transcatheter aortic valve implantation.","authors":"Stefan Toggweiler","doi":"10.4244/EIJ-E-24-00063","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00063","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 2","pages":"e100-e101"},"PeriodicalIF":7.6,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11727679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bringing order to chaos. Invasive functional assessment for all patients in the cath lab?","authors":"Frederik M Zimmermann, Ciro Pollio Benvenuto","doi":"10.4244/EIJ-E-24-00064","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00064","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 1","pages":"14-15"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing the device-related risk of in-stent restenosis and stent thrombosis in coronary stenting.","authors":"Jens Flensted Lassen, Lisette Okkels Jensen","doi":"10.4244/EIJ-E-24-00066","DOIUrl":"https://doi.org/10.4244/EIJ-E-24-00066","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 1","pages":"16-17"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymer-free versus biodegradable-polymer drug-eluting stent in patients undergoing percutaneous coronary intervention: an assessor-blind, non-inferiority, randomised controlled trial.","authors":"Raffaele Piccolo, Paolo Calabrò, Greta Carrara, Attilio Varricchio, Cesare Baldi, Giovanni Napolitano, Ciro De Simone, Ciro Mauro, Eugenio Stabile, Gianluca Caiazzo, Tullio Tesorio, Marco Boccalatte, Bernardino Tuccillo, Plinio Cirillo, Luigi Di Serafino, Fiorenzo Simonetti, Attilio Leone, Domenico Angellotti, Giuseppe Bottiglieri, Enrico Russolillo, Gennaro Galasso, Rocco Perrotta, Arturo Cesaro, Tullio Niglio, Michele Capasso, Alessandra Spinelli, Stefano Cristiano, Antonella Faretra, Dario Bruzzese, Alaide Chieffo, Giuseppe Tarantini, Sergio Leonardi, Simone Biscaglia, Francesco Costa, Salvatore Cassese, Eugene McFadden, Dik Heg, Anna Franzone, Giulio G Stefanini, Davide Capodanno, Giovanni Esposito, For The Parthenope Investigators","doi":"10.4244/EIJ-D-24-00657","DOIUrl":"10.4244/EIJ-D-24-00657","url":null,"abstract":"<p><strong>Background: </strong>Few data are available on polymer-free drug-eluting stents in patients undergoing percutaneous coronary intervention (PCI).</p><p><strong>Aims: </strong>We aimed to determine the efficacy and safety of a polymer-free amphilimus-eluting stent (AES), using a reservoir-based technology for drug delivery, compared with a biodegradable-polymer everolimus-eluting stent (EES).</p><p><strong>Methods: </strong>This was a randomised, investigator-initiated, assessor-blind, non-inferiority trial conducted at 14 hospitals in Italy (ClinicalTrials.gov: NCT04135989). All-comer patients undergoing PCI were randomly assigned to either polymer-free AES or biodegradable-polymer EES. The primary endpoint was a device-oriented composite endpoint, including cardiovascular death, target vessel myocardial infarction, or target lesion revascularisation at 1-year follow-up.</p><p><strong>Results: </strong>Between January 2020 and June 2022, a total of 2,107 patients with 3,042 coronary lesions were randomised to polymer-free AES (1,051 patients) or biodegradable-polymer EES (1,056 patients). At 1-year follow-up, the primary endpoint occurred in 86 (8.2%) patients randomised to polymer-free AES and 76 (7.2%) patients randomised to biodegradable-polymer EES (risk difference 1%, upper limit of the 1-sided 95% confidence interval [CI] of 2.9%; p for non-inferiority=0.041). There were no significant differences in the incidence of the components of the primary endpoint between groups. However, definite or probable stent thrombosis occurred more frequently in patients randomised to polymer-free stents (1.0% vs 0.3%; hazard ratio 3.72, 95% CI: 1.04-13.33; p=0.044) due to an increased risk of early stent thrombosis within 30 day Conclusions: In all-comer patients undergoing PCI, polymer-free AES were non-inferior to biodegradable-polymer EES at 1-year follow-up in terms of a device-oriented composite endpoint despite being associated with an increased risk of early stent thrombosis.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 1","pages":"58-72"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in blood pressure after crossover to ultrasound renal denervation.","authors":"Michael J Bloch, Michel Azizi, Ajay J Kirtane, Felix Mahfoud, Andrew S P Sharp, Maureen McGuire, Candace K McClure, Michael Weber, On Behalf Of The Radiance Investigators","doi":"10.4244/EIJ-D-24-00321","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00321","url":null,"abstract":"","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 1","pages":"93-95"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of enrolment criteria and treatment efficacy for microvascular angina.","authors":"Matthew Hammond-Haley, Kayla Chiew, Fiyyaz Ahmed-Jushuf, Christopher A Rajkumar, Michael J Foley, Florentina A Simader, Shayna Chotai, Matthew J Shun-Shin, Rasha Al-Lamee","doi":"10.4244/EIJ-D-24-00404","DOIUrl":"https://doi.org/10.4244/EIJ-D-24-00404","url":null,"abstract":"<p><strong>Background: </strong>Microvascular angina (MVA) is an important contributor to morbidity and mortality in patients with non-obstructive coronary artery disease. Despite improvements in its recognition and diagnosis, uncertainty remains around the most effective treatment strategy, and more data are needed.</p><p><strong>Aims: </strong>We aimed to evaluate the quality of patient selection in treatment studies of MVA and provide a contemporary overview of the evidence base for the treatment of MVA.</p><p><strong>Methods: </strong>PubMed, the Cochrane Library and Google Scholar were searched from inception to 4 November 2023 for all treatment studies in patients with angina and non-obstructive coronary artery disease or coronary microvascular dysfunction. Populations with acute coronary syndrome were excluded (PROSPERO: CRD42023383075).</p><p><strong>Results: </strong>Forty-three studies were included. By contemporary definitions of MVA according to the Coronary Vasomotor Disorders International Study Group criteria, 11 (26%) studies enrolled patients with \"definitive\" MVA, 24 (56%) with \"suspected\" MVA, and 8 (19%) did not enrol patients who met the diagnostic criteria. A total of 24 unique treatment interventions were investigated. Most studies were observational and single armed (12/24, 50%) or had a single randomised study (9/24, 38%). Ranolazine is the most well-studied intervention drug. Double-blind randomised controlled trials of ranolazine (n=6) have shown inconsistent improvements in Seattle Angina Questionnaire scores and coronary flow reserve with short-term follow-up.</p><p><strong>Conclusions: </strong>Treatment studies of MVA enrolled a heterogeneous population, with only a quarter meeting contemporary diagnostic criteria for definitive MVA. There is a paucity of high quality, randomised data to support any specific treatment intervention. Larger studies with robust selection criteria, blinded patient-reported outcomes, and long-term follow-up are needed.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 1","pages":"46-57"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11702509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Direct oral anticoagulants or warfarin in patients with left ventricular thrombus after ST-elevation myocardial infarction: a pilot trial and a prespecified meta-analysis of randomised trials.","authors":"Yaser Jenab, Parham Sadeghipour, Reza Mohseni-Badalabadi, Raheleh Kaviani, Kaveh Hosseini, Yeganeh Pasebani, Hamid Khederlou, Ali Rafati, Zohre Mohammadi, Sepehr Jamalkhani, Azita Haj Hossein Talasaz, Ata Firouzi, Hamid Ariannejad, Mohammad Javad Alemzadeh-Ansari, Sajjad Ahmadi-Renani, Mohsen Maadani, Melody Farrashi, Hooman Bakhshandeh, Gregory Piazza, Harlan M Krumholz, Roxana Mehran, Gregory Y H Lip, Behnood Bikdeli","doi":"10.4244/EIJ-D-24-00527","DOIUrl":"10.4244/EIJ-D-24-00527","url":null,"abstract":"<p><strong>Background: </strong>The role of direct oral anticoagulants (DOACs) in the treatment of left ventricular thrombus (LVT) after ST-elevation myocardial infarction (STEMI) remains uncertain.</p><p><strong>Aims: </strong>We aimed to compare the effect of rivaroxaban versus warfarin in patients with STEMI complicated by LVT.</p><p><strong>Methods: </strong>Adult patients with STEMI and two-dimensional transthoracic echocardiography showing LVT were assigned to rivaroxaban (15 mg once daily) or warfarin (international normalised ratio goal of 2.0-2.5) in an open-label, randomised clinical trial (RCT). A prospective pooled analysis was planned comparing DOAC- versus warfarin-based anticoagulation for the same indication. The main outcome of the RCT was complete LVT resolution at 3 months, determined by a blinded imaging core laboratory. Complete LVT resolution and bleeding were investigated in the pooled analysis.</p><p><strong>Results: </strong>A total of 50 patients (median age: 55 years, 18% females) were enrolled from June 2020 to November 2022. Three-month complete LVT resolution occurred in 19/25 (76.0%) patients assigned to rivaroxaban and 13/24 (54.2%) assigned to warfarin (relative risk [RR] 1.40, 95% confidence interval [CI]: 0.91-2.15; p=0.12) with no thrombotic or major bleeding events. Pooled analysis showed numerically better complete LVT resolution with DOACs (rivaroxaban and apixaban; 93/115 [80.8%] vs 79/112 [70.5%], RR 1.14, 95% CI: 0.98-1.32; p=0.08) and less major bleeding (2/116 [1.7%] and 9/112 [8.0%], risk difference -0.06, 95% CI: -0.12 to 0.00; p=0.05) than with warfarin.</p><p><strong>Conclusions: </strong>Although the findings are limited by a small sample size, the results suggest that DOACs are safe with at least similar outcomes concerning LVT resolution and major bleeding compared with warfarin. (ClinicalTrials.gov: NCT05705089).</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":"21 1","pages":"82-92"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Usefulness of FFR-CT to exclude haemodynamically significant lesions in high-risk NSTE-ACS.","authors":"David Meier, Daniele Andreini, Bernard Cosyns, Ioannis Skalidis, Tatyana Storozhenko, Thabo Mahendiran, Emilio Assanelli, Jeroen Sonck, Bram Roosens, David C Rotzinger, Salah Dine Qanadli, Georgios Tzimas, Olivier Muller, Bernard De Bruyne, Carlos Collet, Stephane Fournier","doi":"10.4244/EIJ-D-24-00779","DOIUrl":"10.4244/EIJ-D-24-00779","url":null,"abstract":"<p><strong>Background: </strong>Coronary computed tomography angiography (CCTA) and fractional flow reserve (FFR) derived from CCTA (FFR-CT) may provide a means of reducing unnecessary invasive coronary angiography (ICA) in patients with suspected non-ST-elevation acute coronary syndromes (NSTE-ACS).</p><p><strong>Aims: </strong>The aim of this study was to evaluate the capacity of FFR-CT and CCTA to rule out significant lesions in high-risk NSTE-ACS patients, using ICA with invasive FFR as the gold standard.</p><p><strong>Methods: </strong>High-risk NSTE-ACS patients admitted to 4 European centres were enrolled in this single-arm, prospective core lab-adjudicated study. Patients underwent CCTA with FFR-CT analysis, followed by ICA with invasive FFR.</p><p><strong>Results: </strong>Out of the 250 initially planned NSTE-ACS patients, 168 were included, of whom 151 (92%) had sufficient CCTA image quality to undergo CCTA and FFR-CT analysis. The median high-sensitivity troponin T level at 1 hour post-hospitalisation was 5.3 (interquartile range: 1.8-18.6) times the upper reference limit. At the patient level, the diagnostic performance of FFR-CT was numerically higher as compared to CCTA though not statistically significant (sensitivity: 94% vs 93%, specificity: 63% vs 54%, positive predictive value: 83% vs 79%, negative predictive value: 85% vs 80% and accuracy: 83% vs 79%; p=0.58), suggesting an enhanced capability to avoid unnecessary ICA. At the lesion level, the ability of FFR-CT to detect significant lesions was significantly better than that of CCTA (receiver operating characteristic curves: 0.84 vs 0.65 respectively; p<0.01).</p><p><strong>Conclusions: </strong>In patients with high-risk NSTE-ACS, FFR-CT offers better diagnostic accuracy - though not statistically significant - and a higher ability to rule out haemodynamically significant stenoses as compared to CCTA. This indicates that FFR-CT can reduce unnecessary invasive procedures by more accurately identifying patients requiring further intervention.</p>","PeriodicalId":54378,"journal":{"name":"Eurointervention","volume":" ","pages":"73-81"},"PeriodicalIF":7.6,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11684332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}