Application of CT-FFR in Clinical Decision-Making and Prognosis of Coronary Artery Disease

This chapter explores the clinical application and prognostic value of coronary computed tomography-derived fractional flow reserve (CT-FFR) in coronary artery disease (CAD). Compared to invasive FFR, CT-FFR offers a noninvasive, cost-effective alternative for assessing hemodynamic significance of stenosis, integrating anatomical and functional data. Key studies demonstrate CT-FFR’s role in reducing unnecessary invasive coronary angiography (ICA) by 19.4% and optimizing revascularization strategies, particularly in stable chest pain and three-vessel disease. Additionally, CT-FFR enhances risk stratification, predicting major adverse cardiovascular events (MACEs) through short- and long-term studies. Its prognostic utility extends to special populations, including transcatheter aortic valve replacement candidates and diabetics. While CT-FFR improves clinical decision-making and outcomes, further large-scale trials are needed to validate its long-term benefits across diverse patient cohorts.