Lots of interesting abstracts and cases were submitted for TCTAP 2025. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-071
A Meta-Analysis Comparing the Diagnostic Performance of Computed Tomography-Derived Fractional Flow Reserve and Coronary Computed Tomography Angiography for Obstructive CAD in TAVR Planning
By Meichen Sun, Zhao Ma, Yifei Nie, Baoen Zhang, Libo Liu, Chenchen Tu, Dongfeng Zhang, Xiantao Song, Hongjia Zhang
Presenter
Meichen Sun
Authors
Meichen Sun1, Zhao Ma1, Yifei Nie1, Baoen Zhang1, Libo Liu1, Chenchen Tu1, Dongfeng Zhang1, Xiantao Song1, Hongjia Zhang1
Affiliation
Beijing Anzhen Hospital, China1
View Study Report
TCTAP A-071
Computed Tomography
A Meta-Analysis Comparing the Diagnostic Performance of Computed Tomography-Derived Fractional Flow Reserve and Coronary Computed Tomography Angiography for Obstructive CAD in TAVR Planning
Meichen Sun1, Zhao Ma1, Yifei Nie1, Baoen Zhang1, Libo Liu1, Chenchen Tu1, Dongfeng Zhang1, Xiantao Song1, Hongjia Zhang1
Beijing Anzhen Hospital, China1
Background
Computed Tomography Fractional Flow Reserve (CT-FFR) and Coronary Computed Tomography Angiography (CCTA) are potential tools for evaluating obstructive coronary artery disease (CAD) in the planning of Transcatheter Aortic Valve Replacement (TAVR). However, their diagnostic accuracy for clinical application requires further validation. This meta-analysis aims to evaluate and compare the diagnostic efficacy of CT-FFR and CCTA in detecting obstructive CAD in patients scheduled for TAVR.
Methods
We conducted a comprehensive search of PubMed, Embase, and the Cochrane Library for relevant studies on CCTA, CT-FFR, and TAVR. The search strategy included dual approaches to identify studies evaluating the diagnostic performance of CCTA and CT-FFR for pre-TAVR obstructive CAD. We identified 14 studies on CCTA, 8 studies on CT-FFR, and 7 studies on both CCTA and CT-FFR. Invasive FFR or invasive coronary angiography (ICA) served as the reference standards.
Results
Initial results showed CT-FFR had a higher area under the curve (AUC) than CCTA at the per-patient level (0.91 [95% CI 0.88-0.93] vs. 0.82 [95% CI 0.78-0.85], p<0.001). Conversely, CCTA showed a higher AUC than CT-FFR at the per-vessel level, though this difference was not statistically significant (0.83 [95% CI 0.80-0.86] vs. 0.87 [95% CI 0.84-0.90], p=0.064). We refined our selection to studies utilizing both CCTA and CT-FFR. Results indicated that CT-FFR had a superior AUC compared to CCTA, both per-patient (0.92 [95% CI 0.90-0.94] vs. 0.69 [95% CI 0.65-0.73], p<0.001) and per-vessel (0.84 [95% CI 0.84-0.87] vs. 0.77 [95% CI 0.74-0.81], p<0.001).
Conclusion
CT-FFR demonstrates superior diagnostic performance compared to CCTA in detecting obstructive CAD during TAVR planning.The implementation of CT-FFR prior to TAVR can enhance the diagnostic accuracy for obstructive CAD, potentially reducing the need for additional invasive coronary angiographies. This can lead to lower healthcare costs and mitigate risks and complexities associated with excessive diagnosis and treatment.