In 56 coronary artery stenoses (42 patients) we performed CCTA, quantitative coronary angiography and FFR. CCTA measurements included diameter stenosis (DS, % ), area stenosis (AS, % ), minimal lumen diameter (MLD, mm), minimal lumen area (MLA, mm2), lesion length (LL, mm), plaque volume (mm3) and burden ( % ).
FFR averaged 0.81 ± 0.14, and 10 lesions had an abnormal FFR (< 0.75). We found significant correlations between FFR and DS (r = − 0.67, p < 0.001), AS (r = − 0.68, p < 0.001), MLD (r = 0.58, p < 0.001), MLA (r = 0.53, p < 0.001), LL (r = − 0.36, p = 0.02), plaque volume (r = − 0.36, p = 0.02) and plaque burden (r = − 0.59, p < 0.001). By multivariate regression analysis AS and LL were the strongest determinants of an abnormal FFR. The optimal cut-off value for AS was > 73 % (sensitivity 90 % , specificity 80 % , negative predictive value 97 % , and positive predictive value 50 % ) and for LL > 10 mm (sensitivity 60 % and specificity 49 % ).
This study demonstrates that quantitative CCTA is correlated to FFR. Using our CCTA criteria of abnormality, significant coronary artery stenoses can be ruled out with a high negative predictive value.