New Technology Weeds Out Patients Who Don’t Need Heart Catheterizations

Chest pain is a symptom of coronary artery disease, and patients are often sent to a cardiac catheterization lab either directly or after stress testing for an invasive procedure to detect blockages.

But cardiac catheterization can be avoided in many patients, according to new findings by a Duke Medicine-led research team. In 73 percent of cases in which conventional care was used, the Duke team found that invasive cardiac catheterization identified no significant blockages.

Another parallel group of similar patients with chest pain was instead channeled to first get a cardiac computed tomographic angiography (CTA) scan, followed in many cases by a new test that measures the extent to which coronary blockages are disrupting blood flow. This test is called fractional flow reserve analysis by CT, or FFRCT.

The Duke team found that the CTA and FFRCT group fared dramatically better, with only 12 percent of patients having to undergo a catheterization only to find no significant blockages. Using the FFRCT analysis, physicians were able to completely cancel a scheduled invasive procedure in more than 60 percent of patients.