ArticleCardiovascular diabetology2023
Global trans-lesional computed tomography-derived fractional flow reserve gradient is associated with clinical outcomes in diabetic patients with non-obstructive coronary artery disease.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Pooled it
- Clinical use of coronary computed tomography angiography-derived fractional flow reserve: expert consensus by an International Working Group.European radiology · 2026Article
- Multiparametric Coronary CT Angiography-Derived Imaging Biomarkers for Risk Stratification in Nonobstructive Coronary Artery Disease: Incremental Prognostic Value in Patients with Diabetes.Tomography (Ann Arbor, Mich.) · 2026Article
- A Pathophysiology-Oriented Imaging Phenotype Framework for Nonobstructive Coronary Artery Disease.Journal of cardiovascular development and disease · 2026Article
- CT-derived fractional flow reserve combined with atherosclerotic extent to determine long-term outcomes in diabetic patients with coronary artery disease.Journal of geriatric cardiology : JGC · 2026Article
- Long-term prognostic value of the CT-derived fractional flow reserve combined with atherosclerotic burden in patients with non-obstructive coronary artery disease.European radiology · 2025Article
- Incremental prognostic value of ischemic score quantified by stress dynamic CT myocardial perfusion in patients with and without diabetes mellitus.Scientific reports · 2025Article
- Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve: A Comprehensive Review.Reviews in cardiovascular medicine · 2025Review
- Computed Tomography and Coronary Plaque Analysis.Tomography (Ann Arbor, Mich.) · 2025Review
- Prognostic Significance of Computed Tomography-Derived Fractional Flow Reserve for Long-Term Outcomes in Individuals With Coronary Artery Disease.Journal of the American Heart Association · 2025Article
- Computed Tomography-Derived Fractional Flow Reserve: Developing A Gold Standard for Coronary Artery Disease Diagnostics.Reviews in cardiovascular medicine · 2024Review
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCoronary computed tomography angiography (CCTA)-derived fractional flow reserve (CT-FFR) enables physiological assessment and risk stratification, which is of significance in diabetic patients with nonobstructive coronary artery disease (CAD). We aim to evaluate prognostic value of the global trans-lesional CT-FFR gradient (GΔCT-FFR), a novel metric, in patients with diabetes without flow-limiting stenosis.
methodsPatients with diabetes suspected of having CAD were prospectively enrolled. GΔCT-FFR was calculated as the sum of trans-lesional CT-FFR gradient in all epicardial vessels greater than 2 mm. Patients were stratified into low-gradient without flow-limiting group (CT-FFR > 0.75 and GΔCT-FFR < 0.20), high-gradient without flow-limiting group (CT-FFR > 0.75 and GΔCT-FFR ≥ 0.20), and flow-limiting group (CT-FFR ≤ 0.75). Discriminant ability for major adverse cardiovascular events (MACE) prediction was compared among 4 models [model 1: Framingham risk score; model 2: model 1 + Leiden score; model 3: model 2 + high-risk plaques (HRP); model 4: model 3 + GΔCT-FFR] to determine incremental prognostic value of GΔCT-FFR.
resultsOf 1215 patients (60.1 ± 10.3 years, 53.7% male), 11.3% suffered from MACE after a median follow-up of 57.3 months. GΔCT-FFR (HR: 2.88, 95% CI 1.76-4.70, P < 0.001) remained independent risk factors of MACE in multivariable analysis. Compared with the low-gradient without flow-limiting group, the high-gradient without flow-limiting group (HR: 2.86, 95% CI 1.75-4.68, P < 0.001) was associated with higher risk of MACE. Among the 4 risk models, model 4, which included GΔCT-FFR, showed the highest C-statistics (C-statistics: 0.75, P = 0.002) as well as a significant net reclassification improvement (NRI) beyond model 3 (NRI: 0.605, P < 0.001).
conclusionsIn diabetic patients with non-obstructive CAD, GΔCT-FFR was associated with clinical outcomes at 5 year follow-up, which illuminates a novel and feasible approach to improved risk stratification for a global hemodynamic assessment of coronary artery in diabetic patients.
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