Computed Tomography-derived Fractional Flow Reserve vs. Angiographic Quantitative Flow Ratio in Management of Patients With Coronary Artery Disease

NCT ID: NCT07308496

Last Updated: 2025-12-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

1402 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-01-01

Study Completion Date

2028-07-01

Brief Summary

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This is a multi-center, randomized controlled trial to compare the clinical outcomes between CT-derived fractional flow reserve (CT-FFR) guided strategy and angiography-derived quantitative flow ratio (QFR) guided strategy among patients with coronary artery disease (CAD). Participants who have at least one coronary stenosis of 70%-90% (vessel diameter ≥2.5 mm) detected by coronary CT angiography will be enrolled and are randomly assigned in a 1:1 ratio to CT-FFR guided group or QFR guided group. In CT-FFR group, the decisions of invasive angiography and revascularization will be guided by CT-FFR. In QFR group, the decision of invasive angiography will be made as usual care, and revascularization will be guided by QFR. The primary endpoint is the 1-year incidence of major adverse cardiac events (MACEs), including death, myocardial infarction, and unplanned revascularization.

Detailed Description

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Conditions

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Coronary Artery Disease

Keywords

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CT-derived fractional flow reserve Angiography-derived quantitative flow ratio

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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CT-FFR group

The decisions of invasive angiography and revascularization will be guided by CT-FFR.

Group Type EXPERIMENTAL

CT-FFR guided strategy

Intervention Type DIAGNOSTIC_TEST

Patients in this group will undergo CT-derived fractional flow reserve (CT-FFR) analysis. If the CT-FFR value is ≤0.80, patients will subsequently undergo invasive coronary angiography (ICA) and receive coronary revascularization. If the CT-FFR values of all vessels are \>0.80, patients will not undergo invasive angiography.

QFR group

The decision of invasive angiography will be made as usual care, and revascularization will be guided by QFR.

Group Type ACTIVE_COMPARATOR

QFR guided strategy

Intervention Type DIAGNOSTIC_TEST

Patients in this group will undergo invasive coronary angiography (ICA) according to routine clinical indications. During the procedure, quantitative flow ratio (QFR) analysis will be performed. If the QFR value is ≤0.80, coronary revascularization will be performed. If the QFR value is \>0.80, coronary revascularization will be forwent.

Interventions

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CT-FFR guided strategy

Patients in this group will undergo CT-derived fractional flow reserve (CT-FFR) analysis. If the CT-FFR value is ≤0.80, patients will subsequently undergo invasive coronary angiography (ICA) and receive coronary revascularization. If the CT-FFR values of all vessels are \>0.80, patients will not undergo invasive angiography.

Intervention Type DIAGNOSTIC_TEST

QFR guided strategy

Patients in this group will undergo invasive coronary angiography (ICA) according to routine clinical indications. During the procedure, quantitative flow ratio (QFR) analysis will be performed. If the QFR value is ≤0.80, coronary revascularization will be performed. If the QFR value is \>0.80, coronary revascularization will be forwent.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

1. Adults aged ≥18 years.
2. Patients with stable angina, unstable angina, or post-myocardial infarction ≥72 hours.
3. Patients are able and willing to provide written informed consent.


(1) Coronary CT angiography (CCTA) shows at least one coronary artery with 70%-90% diameter stenosis and vessel diameter ≥2.5 mm.

Exclusion Criteria

1. Previous percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
2. Suspected acute myocardial infarction (ECG or biomarkers indicating acute phase).
3. Moderate to severe chronic kidney disease, defined as serum creatinine \>150 μmol/L or estimated glomerular filtration rate (eGFR) \<45 mL/min/1.73 m².
4. Severe valvular heart disease, aortic disease, or large ventricular aneurysm requiring surgery.
5. Atrial fibrillation or other severe cardiac arrhythmias.
6. Refusal or inability to sign informed consent.


1. Poor-quality CCTA images that prevent CT-FFR analysis.
2. Severe coronary vessel tortuosity, overlapping segments, or other factors expected to cause poor-quality invasive angiography, hindering QFR measurement.
3. Combined with chronic total occlusion lesions.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fuwai Yunnan Cardiovascular Hospital

OTHER

Sponsor Role collaborator

Central China Fuwai Hospital of Zhengzhou University

OTHER

Sponsor Role collaborator

Shenzhen Sun Yat-sen Cardiovascular Hospital

OTHER

Sponsor Role collaborator

Ruijin Hospital

OTHER

Sponsor Role collaborator

Nanjing First Hospital, Nanjing Medical University

OTHER

Sponsor Role collaborator

The First Affiliated Hospital with Nanjing Medical University

OTHER

Sponsor Role collaborator

Union Hospital, Tongji Medical College, Huazhong University of Science and Technology

OTHER

Sponsor Role collaborator

The First Affiliated Hospital of Dalian Medical University

OTHER

Sponsor Role collaborator

Chinese Academy of Medical Sciences, Fuwai Hospital

OTHER

Sponsor Role collaborator

China National Center for Cardiovascular Diseases

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Central Contacts

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Zhe Zheng, MD, PhD

Role: CONTACT

Phone: +86 88396051

Email: [email protected]

Other Identifiers

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2025-2855

Identifier Type: -

Identifier Source: org_study_id