Introduction: The burden of coronary artery disease has been assessed by various semi-quantitative angiographic scores, which are frequently distinct. A non-invasive and quantitative modality may substitute angiographic sores for prognostic implication and decision of revascularization strategy. We compared fractional myocardial mass (FMM) with angiographic scores and also with performing percutaneous coronary intervention (PCI).
Methods: In this multicenter prospective registry, a total of 412 patients who underwent coronary computed tomography angiography (CCTA) were followed by invasive coronary angiography and fractional flow reserve (FFR) measurement. PCI was performed in 282 patients (68%). CCTA-derived FMM with diameter stenosis (DS)≥70% (%FMM-70) or ≥50% (%FMM-50) were compared with 9 angiographic scoring systems (APPROACH, Duke Jeopardy, modified Duke, Leaman, Jenkins, BARI, BCIS-1, CASS, and SYNTAX).
Results: The PCI predicting performance of %FMM-70 (c-statistics=0.80) and %FMM-50 (0.78) were similar and comparable to angiographic scores (0.71-0.81). In any category of %FMM=0 to 59%, PCI was increasingly performed according to %FMM and was more frequently performed in DS≥70% than DS≥50% (p<0.05, all).
Conclusions: %FMM correlated well with angiographic scores and showed comparable PCI predicting performance. %FMM has a potential to be used as an alternative to the angiographic scores in a noninvasive and quantitative manner. PCI was performed respecting both the amount of jeopardized myocardium and severity of stenosis.