CCTA-Derived Fractional Flow Reserve Facilitates 44 Percent Reduction in ICA Procedures for Patients with Obstructive Stenosis

For patients with stable chest pain and obstructive stenosis, the use of fractional flow reserve (FFR_CT) based off coronary computed tomography angiography (CCTA) exams led to significant decreases in unnecessary invasive coronary angiography (ICA) procedures in comparison to those who had CCTA exams alone, according to research presented at the European Society of Cardiology (ESC) conference.

For the FUSION study, a multicenter randomized controlled trial, researchers compared the use of FFR_CT Analysis (Heartflow) and standard of care (SOC) at 90 days and one year in 528 patients (median age of 63) with stable chest pain and 50 to 90 percent stenosis in > 1 coronary artery on CCTA.¹

The study authors found that 18 percent of the FFR_CT group had unnecessary ICA procedures at 90 days in comparison to 33 percent in the SOC cohort. The researchers noted an overall reduction of ICA procedures with the use of FFR_CT (39 percent vs. 51 percent).¹

The differences in unnecessary and overall ICA procedures remained the same at one year, according to the study authors. They also noted no statistically significant differences between those who had FFR_CT and the SOC cohort with respect to revascularization procedures and major adverse cardiovascular events (MACE).¹

“Adding FFRct to the diagnostic pathway of patients with a 50-90% stenosis on CCTA reduced the rate of unnecessary ICA and overall ICA use at 90 days and 1 year, without differences in revascularisations, clinical events, quality of life, and costs compared to usual care,” said study co-author Alexander Hirsch, MD, an associate professor of cardiology at Erasmus MC in Rotterdam, the Netherlands, and colleagues.

Campbell Rogers, MD, FACC, emphasized a longstanding challenge of identifying whether patients have severe disease that warrants an invasive procedure prior to patients undergoing catheterization.²

“The FUSION data demonstrate that our technology can meaningfully address this challenge, providing physicians with more precise insight into a patient's disease burden after CCTA has documented stenosis over 50 percent. This allows care teams to direct invasive procedures to the patients most likely to benefit, while sparing others the risk and burden of a catheterization they may not require,” noted Rogers, the chief medical officer of Heartflow.

References

1. Addition of computed tomography-derived fractional flow reserve in the diagnostic pathway of patients with stable coronary artery disease: the FUSION randomized controlled trial. Presented at the European Society of Cardiology (ESC) conference, August 28-31, 2026, Munich, Germany.

2. Heartflow. Late breaking data from independent government-funded trial at ESC shows Heartflow FFRCT Analysis reduces unnecessary invasive heart procedures by nearly half. Available at: https://www.globenewswire.com/news-release/2026/08/28/3352507/0/en/late-breaking-data-from-independent-government-funded-trial-at-esc-shows-heartflow-ffrct-analysis-reduces-unnecessary-invasive-heart-procedures-by-nearly-half.html . Published August 28, 2026. Accessed August 28, 2026.