Is CT Stress Perfusion Comparable to FFR in Assessing Ischemic Heart Disease? Multicenter Trial PERFUSE

SPCP21D

Is CT Stress Perfusion Comparable to FFR in Assessing Ischemic Heart Disease? Multicenter Trial PERFUSE

Special Courses

Presented on December 1, 2014
Presented as part of SPCP21: Korea Presents: Exploring Evidence in Cardiovascular Imaging

Byoung Wook Choi MD, Presenter: Nothing to Disclose

1) Understand the clinical role and indication of myocardial perfusion with computed tomography. 2) Acess the study design and rationale to compare myocardial perfusion with computed tomography with FFR regarding to clinical utility. 3) Able to set up a proper protocol of computed tomography for myocardial perfusion in clinical practice. 4) Assess the technical advances and consideration of computed tomography in myocardial perfusion. This session is part of Korea Presents at RSNA 2014.

The FAME trial demonstrated the superiority of FFR (fractional flow reserve)-guided revascularization strategy over angiography-guided treatment. The functional significance of coronary artery stenosis is now considered as the standard reference for revascularization. Non-invasive imaging for myocardial ischemia can be used for identifying functionally significant stenosis as well. Evaluation of myocardial ischemia by using CT has been reported as a new alternative non-invasive method. According to a recent study, as compared to FFR and invasive angiography, the combination of CT angiography (CTA) and CT perfusion (CTP) was highly accurate in detection and exclusion of myocardial ischemia. The PERFUSE (Stress Coronary PErfusion Versus FRactional Flow Reserve GUided PercutaneouS Coronary IntErvention) trial is a multicenter, randomized, controlled, noninferiority trial in the comparison of CTP- and FFR-guided percutaneous coronary intervention (PCI). The objective of this trial is to compare outcomes of composite of any of all cause mortality, myocardial infarction, and unplanned hospitalization with revascularization at 1 year after CTP-guided PCI to FFR-guided PCI in angina patients with coronary artery disease. The inclusion criteria is patients who referred for CTA because of angina or angina equivalent symptom and having more than 70% diameter stenosis at least one major epicardial coronary artery on CTA. A total 1000 patient will be enrolled (500 per each arm) and randomized to either FFR guided or CTP-guided groups. Twenty centers in Korea are participating in the study.