Background Image
Previous Page  19 / 22 Next Page
Basic version Information
Show Menu
Previous Page 19 / 22 Next Page
Page Background

page

nineteen

Case study:

A 55-year-old woman complained of unusual chest pain that began one month

ago. She had no history of myocardial infarction or cardiovascular disease,

but had recently been diagnosed with Type 2 diabetes, hypertension and

hyperlipidaemia. She had a long history of smoking although had recently

given up. She had a sedentary lifestyle and did very little exercise.

An exercise stress test revealed no significant ECG abnormality and did not

cause her any chest pain. However, she subsequently underwent a high

definition low dose coronary CT scan which showed that she had calcified

coronary arteries with a possibly significant lesion in the proximal Left Anterior

Descending coronary artery (LAD).

Her cardiologist decided to perform a non-invasive HeartFlow FFRct® Analysis,

which showed a functionally significant stenosis with a computed FFRct®

value of 0.66. The finding of an ischaemia-producing lesion in the LAD was

subsequently confirmed at the time of invasive coronary angiography, with

direct measurement of Fractional Flow Reserve (FFR) using a pressure wire.

The measured FFR was 0.67, which closely matched the computed value from

the HeartFlow study.

With a clear diagnosis of ischaemia, the patient was treated at the same

procedure with a coronary stent, which relieved her unusual chest pain

symptoms. One year later, she had not experienced any further chest pains,

felt completely well and was actively engaged in a structured exercise

programme and walking on a daily basis.

Coronary artery disease and diagnosis

Coronary artery disease is the leading cause of death in the UK, affecting more

than one in seven men and nearly one in ten women.

1

Despite the widespread

use of non-invasive cardiac diagnostic testing, functionally significant coronary

disease is often missed while, at the same time, many patients with positive

stress tests have no significant disease.

In a study of almost 400,000 patients with suspected coronary artery disease

who underwent Invasive Coronary Angiography (ICA), 84% had prior non-

invasive tests, but more than 60% had no evidence of obstructive coronary

disease on angiography.

2

A recent multicentre trial showed that using

HeartFlow FFRct® Analysis improved the selection of patients for coronary

angiography with more than 80% reduction in the number of angiograms

showing no obstructive disease, and a significant reduction in healthcare cost.

Coronary Heart Disease

(CHD) Statistics for the UK

1

CHD is responsible for nearly

70,000 deaths in the UK each

year, an average of 190 people

each day, or one death around

every eight minutes. Most deaths

from coronary heart disease are

caused by a heart attack.

More than 22,000 people under

the age of 75 in the UK die from

CHD each year.

CHD death rates are highest

in Scotland and the north of

England and lowest in the

south of England.

CHD kills more than twice as

many women as breast cancer.

2.3 million people are living

with CHD in the UK – over 60%

are male.

References

1.

British Heart Foundation

Cardiovascular Statistics UK

Fact Sheet.

2. Patel et al,

Prevalence and

predictors of non-obstructive

coronary artery disease identified

with coronary angiography in

contemporary clinical practice.

American Heart Journal 2014;

167: 846-852.e2.

For more information, please contact the

GP Liaison Department

on:

T: 020 7234 2009

HeartFlow FFRct®

MORE THAN 22,000

PEOPLE UNDER THE

AGE OF 75 IN THE UK DIE

FROM CHD EACH YEAR

1

.