Trial Outcomes & Findings for The PLATFORM Study: Prospective LongitudinAl Trial of FFRct: Outcome and Resource IMpacts) (NCT NCT01943903)

NCT ID: NCT01943903

Last Updated: 2025-09-05

Results Overview

The primary endpoint of the PLATFORM Study is 90 day (+30/-15 days) rate of coronary angiogram showing no stenosis \> 50% in a vessel \> 2.0 mm by Quantitative Coronary Angiography (QCA), or no invasively-measured FFR \< 0.80 in a segment distal to a stenosis in a vessel \> 2.0 mm by QCA between Cohort 1 and 2.

Recruitment status

COMPLETED

Target enrollment

584 participants

Primary outcome timeframe

90 Days from first test

Results posted on

2025-09-05

Participant Flow

Subjects will be referred for non-invasive and/or invasive testing and evaluation. Prior to treatment of each subject considered for percutaneous coronary intervention (PCI) and/or coronary artery bypass grafting (CABG), the investigator and the institution's heart team will review clinical data and results of the diagnostic tests to recommend a treatment strategy, according to the institution's standard practice.

Patients were eligible for enrollment if they were symptomatic, had an intermediate likelihood of CAD, did not have an established diagnosis of CAD, and were referred for clinically indicated testing to evaluate CAD. Patients referred for noninvasive testing were enrolled in a separate stratum than patients referred for invasive testing. The choice to refer the patient for invasive testing rather than noninvasive testing was made by the local clinicians before enrollment in the study.

Participant milestones

Participant milestones
Measure
Non-invasive (Cohort 2) Usual Care
(Cohort 2) Subjects will be referred for non-invasive and/or invasive testing and evaluation. Prior to treatment of subjects considered for PCI and/or CABG, the investigator and the institution's heart team will review the results of all available diagnostic tests, including cCTA and FFRCT, and will recommend a treatment strategy accordingly.
Non-invasive Cohort (Cohort 2) FFRCT
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Invasive Cohort (Cohort 1) Usual Care
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Overall Study
STARTED
100
104
187
193
Overall Study
COMPLETED
100
104
187
193
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The PLATFORM Study: Prospective LongitudinAl Trial of FFRct: Outcome and Resource IMpacts)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Invasive Cohort (Cohort 1) Usual Care
n=187 Participants
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 Participants
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Non-invasive (Cohort 2) Usual Care
n=100 Participants
(Cohort 2) Subjects will be referred for non-invasive and/or invasive testing and evaluation. Prior to treatment of subjects considered for PCI and/or CABG, the investigator and the institution's heart team will review the results of all available diagnostic tests, including cCTA and FFRCT, and will recommend a treatment strategy accordingly.
Non-invasive Cohort (Cohort 2) FFRCT
n=104 Participants
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Total
n=584 Participants
Total of all reporting groups
Age, Continuous
63.36 years
STANDARD_DEVIATION 10.93 • n=5 Participants
60.72 years
STANDARD_DEVIATION 10.20 • n=7 Participants
57.91 years
STANDARD_DEVIATION 10.72 • n=5 Participants
59.48 years
STANDARD_DEVIATION 9.33 • n=4 Participants
60.86 years
STANDARD_DEVIATION 10.54 • n=21 Participants
Sex: Female, Male
Female
79 Participants
n=5 Participants
74 Participants
n=7 Participants
34 Participants
n=5 Participants
44 Participants
n=4 Participants
231 Participants
n=21 Participants
Sex: Female, Male
Male
108 Participants
n=5 Participants
119 Participants
n=7 Participants
66 Participants
n=5 Participants
60 Participants
n=4 Participants
353 Participants
n=21 Participants
Diabetes
36 Participants
n=5 Participants
30 Participants
n=7 Participants
8 Participants
n=5 Participants
6 Participants
n=4 Participants
80 Participants
n=21 Participants
Current smoker
42 Participants
n=5 Participants
38 Participants
n=7 Participants
22 Participants
n=5 Participants
23 Participants
n=4 Participants
125 Participants
n=21 Participants
Hypertension
111 Participants
n=5 Participants
111 Participants
n=7 Participants
38 Participants
n=5 Participants
57 Participants
n=4 Participants
317 Participants
n=21 Participants
Hyperlipidemia
76 Participants
n=5 Participants
77 Participants
n=7 Participants
22 Participants
n=5 Participants
28 Participants
n=4 Participants
203 Participants
n=21 Participants
Atypical angina
122 Participants
n=5 Participants
142 Participants
n=7 Participants
91 Participants
n=5 Participants
80 Participants
n=4 Participants
435 Participants
n=21 Participants
Prior noninvasive testing
92 Participants
n=5 Participants
100 Participants
n=7 Participants
0 Participants
n=5 Participants
5 Participants
n=4 Participants
197 Participants
n=21 Participants
Pre-test probability of CAD
97 Participants
n=5 Participants
95 Participants
n=7 Participants
56 Participants
n=5 Participants
47 Participants
n=4 Participants
295 Participants
n=21 Participants

PRIMARY outcome

Timeframe: 90 Days from first test

Population: ICA - Invasive coronary angiography. Independent core laboratories performed quantitative coronary angiography.

The primary endpoint of the PLATFORM Study is 90 day (+30/-15 days) rate of coronary angiogram showing no stenosis \> 50% in a vessel \> 2.0 mm by Quantitative Coronary Angiography (QCA), or no invasively-measured FFR \< 0.80 in a segment distal to a stenosis in a vessel \> 2.0 mm by QCA between Cohort 1 and 2.

Outcome measures

Outcome measures
Measure
Planned Invasive Test Usual Care Strategy (Cohort 1B)
n=187 Participants
Cohort 1B consisted of subjects who were referred for ICA and were evaluated and treated according to standard practice.
Planned Invasive Test FFRCT Guided Strategy (Cohort 2B)
n=193 Participants
Cohort 2B also consisted of subjects who were referred for ICA, but instead had cCTA imaging, and then at the investigators discretion had FFRCT analysis performed.
Invasive Cohort (Cohort 1) Usual Care
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Number of Participants With Negative Invasive Coronary Angiography
137 Participants
24 Participants

SECONDARY outcome

Timeframe: 90 days from first test

Population: The analysis population was defined as all subjects who were enrolled into the study. Safety was monitored throughout the study. The low number of MACE events made it impossible to analyze the powered secondary endpoint. None of the events were related to the FFRCT.

90 days (+30/-30 days) Cohort 1 and Cohort 2 Major Adverse Coronary Event (MACE) rates, defined as: 1. All cause death 2. Non-fatal MI 3. Unplanned hospitalization for acute coronary syndrome (ACS) leading to urgent revascularization

Outcome measures

Outcome measures
Measure
Planned Invasive Test Usual Care Strategy (Cohort 1B)
n=100 Participants
Cohort 1B consisted of subjects who were referred for ICA and were evaluated and treated according to standard practice.
Planned Invasive Test FFRCT Guided Strategy (Cohort 2B)
n=104 Participants
Cohort 2B also consisted of subjects who were referred for ICA, but instead had cCTA imaging, and then at the investigators discretion had FFRCT analysis performed.
Invasive Cohort (Cohort 1) Usual Care
n=187 Participants
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 Participants
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Number of MACE
1 Participants
0 Participants
2 Participants
2 Participants

SECONDARY outcome

Timeframe: 90 days from first test

Population: The analysis population was defined as all subjects who were enrolled into the study. It is important to note that none of the adverse events reported throughout the study were related to FFRCT.

90 days (+30/-30 days) Major Adverse Coronary Event (MACE) rates, defined as: all cause death, non-fatal MI, unplanned hospitalization for acute coronary syndrome (ACS) leading to urgent revascularization and vascular complications (related to any coronary testing or procedure).This secondary endpoint compared the rates of MACE and vascular events across all subjects in Cohort 1 vs Cohort 2, Cohort 1A vs Cohort 2A and Cohort 1B vs Cohort 2B. The rates of MACE and vascular events were calculated by dividing the number of subjects with MACE and vascular events by the total number of subjects assigned to each analysis population.

Outcome measures

Outcome measures
Measure
Planned Invasive Test Usual Care Strategy (Cohort 1B)
n=100 Participants
Cohort 1B consisted of subjects who were referred for ICA and were evaluated and treated according to standard practice.
Planned Invasive Test FFRCT Guided Strategy (Cohort 2B)
n=104 Participants
Cohort 2B also consisted of subjects who were referred for ICA, but instead had cCTA imaging, and then at the investigators discretion had FFRCT analysis performed.
Invasive Cohort (Cohort 1) Usual Care
n=187 Participants
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 Participants
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Number of MACE or Vascular Complications
0 Participants
1 Participants
2 Participants
7 Participants

SECONDARY outcome

Timeframe: 90 days from first test

Comparison of Resource utilization between cohort 1 and cohort 2 at 90 days (+/- 30 days): 1. Non-invasive diagnostic tests 2. Invasive diagnostic tests 3. Coronary revascularization procedures

Outcome measures

Outcome measures
Measure
Planned Invasive Test Usual Care Strategy (Cohort 1B)
n=100 Participants
Cohort 1B consisted of subjects who were referred for ICA and were evaluated and treated according to standard practice.
Planned Invasive Test FFRCT Guided Strategy (Cohort 2B)
n=104 Participants
Cohort 2B also consisted of subjects who were referred for ICA, but instead had cCTA imaging, and then at the investigators discretion had FFRCT analysis performed.
Invasive Cohort (Cohort 1) Usual Care
n=187 Participants
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 Participants
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
Stress Echo
2 Participants
0 Participants
7 Participants
6 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
cCTA with FFRCT
0 Participants
17 Participants
0 Participants
64 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
ECG
2 Participants
3 Participants
59 Participants
32 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
Nuclear/Stress MPI/CMR
3 Participants
2 Participants
23 Participants
5 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
cCTA without FFRCT
8 Participants
2 Participants
21 Participants
12 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
IVUS, OCT, or FFR
3 Participants
7 Participants
17 Participants
30 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
ICA
12 Participants
19 Participants
187 Participants
76 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
PCI
3 Participants
9 Participants
42 Participants
45 Participants
Number of Participants With Resource (CV Test Types Performed) Utilization at 90 Days
CABG
2 Participants
1 Participants
17 Participants
10 Participants

SECONDARY outcome

Timeframe: at 90 days

Population: Values are the total number of patients who used particular medication (multiple medication types might be used per each patient)

Comparison of medication use between cohort 1A, 1B and cohort 2A, 2B at 90 days (+/- 15 days)

Outcome measures

Outcome measures
Measure
Planned Invasive Test Usual Care Strategy (Cohort 1B)
n=100 Participants
Cohort 1B consisted of subjects who were referred for ICA and were evaluated and treated according to standard practice.
Planned Invasive Test FFRCT Guided Strategy (Cohort 2B)
n=104 Participants
Cohort 2B also consisted of subjects who were referred for ICA, but instead had cCTA imaging, and then at the investigators discretion had FFRCT analysis performed.
Invasive Cohort (Cohort 1) Usual Care
n=187 Participants
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 Participants
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Number of Participants With Medications Used by Type
Statin
24 participants (total count)
29 participants (total count)
83 participants (total count)
77 participants (total count)
Number of Participants With Medications Used by Type
Aspirin
29 participants (total count)
45 participants (total count)
115 participants (total count)
90 participants (total count)

Adverse Events

Non-invasive (Cohort 2) Usual Care

Serious events: 2 serious events
Other events: 6 other events
Deaths: 0 deaths

Non-invasive Cohort (Cohort 2) FFRCT

Serious events: 1 serious events
Other events: 13 other events
Deaths: 0 deaths

Invasive Cohort (Cohort 1) Usual Care

Serious events: 6 serious events
Other events: 137 other events
Deaths: 1 deaths

Invasive Cohort (Cohort 1) FFRCT

Serious events: 9 serious events
Other events: 24 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Non-invasive (Cohort 2) Usual Care
n=100 participants at risk
(Cohort 2) Subjects will be referred for non-invasive and/or invasive testing and evaluation. Prior to treatment of subjects considered for PCI and/or CABG, the investigator and the institution's heart team will review the results of all available diagnostic tests, including cCTA and FFRCT, and will recommend a treatment strategy accordingly.
Non-invasive Cohort (Cohort 2) FFRCT
n=104 participants at risk
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Invasive Cohort (Cohort 1) Usual Care
n=187 participants at risk
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 participants at risk
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Cardiac disorders
All-cause death
0.00%
0/100 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.00%
0/104 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.53%
1/187 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.00%
0/193 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
Cardiac disorders
Nonfatal MI
1.0%
1/100 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.00%
0/104 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.53%
1/187 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.52%
1/193 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
Cardiac disorders
Hospitalization with urgent revascularization
0.00%
0/100 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.00%
0/104 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.00%
0/187 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.52%
1/193 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
Cardiac disorders
MACE or vascular complications
1.0%
1/100 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
0.96%
1/104 • Number of events 1 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
2.1%
4/187 • Number of events 4 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
3.6%
7/193 • Number of events 7 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.

Other adverse events

Other adverse events
Measure
Non-invasive (Cohort 2) Usual Care
n=100 participants at risk
(Cohort 2) Subjects will be referred for non-invasive and/or invasive testing and evaluation. Prior to treatment of subjects considered for PCI and/or CABG, the investigator and the institution's heart team will review the results of all available diagnostic tests, including cCTA and FFRCT, and will recommend a treatment strategy accordingly.
Non-invasive Cohort (Cohort 2) FFRCT
n=104 participants at risk
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Invasive Cohort (Cohort 1) Usual Care
n=187 participants at risk
(Cohort 1) of the study is an observational evaluation of resource utilization and outcomes based on standard practice for diagnosis and treatment of subjects with symptomatic suspected CAD and intermediate likelihood of obstructive CAD.
Invasive Cohort (Cohort 1) FFRCT
n=193 participants at risk
The second cohort of patients, enrolled after completion of the enrollment of the first cohort, was evaluated by CTA, with determination of FFRCT when a lesion of $30% stenosis was detected, or the patient was referred to invasive angiography.
Cardiac disorders
Invasive catheterization without obstructive CAD
6.0%
6/100 • Number of events 100 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
12.5%
13/104 • Number of events 104 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
73.3%
137/187 • Number of events 187 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.
12.4%
24/193 • Number of events 193 • Clinical Outcomes at 1 Year
All AEs were submitted to the independent clinical events committee (CEC) for review and adjudication. CEC adjudicated all MACE events in a blinded fashion using standard, prospectively determined definitions as described in Protocol.

Additional Information

VP, Clinical

HeartFlow

Phone: 408-314-2335

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: LTE60