Determination of Fractional Flow Reserve by Anatomic Computed Tomographic Angiography

Exclusion Criteria

• •Prior coronary artery bypass graft (CABG) surgery
• •Prior percutaneous coronary intervention (PCI) for which suspected coronary artery lesion(s) are within a stented coronary vessel
• •Contraindication to adenosine, including 2nd or 3rd degree heart block; sick sinus syndrome; long QT syndrome; severe hypotension, severe asthma, , severe COPD or bronchodilator-dependent COPD
• •Suspicion of acute coronary syndrome (acute myocardial infarction and unstable angina)
• •Recent prior myocardial infarction within 40 days of ICA
• •Known complex congenital heart disease
• •Prior pacemaker or internal defibrillator lead implantation
• •Prosthetic heart valve
• •Significant arrhythmia or tachycardia
• •Impaired chronic renal function (serum creatinine \>1.5 mg/dl
• •Patients with known anaphylactic allergy to iodinated contrast
• •Pregnancy or unknown pregnancy status
• •Body mass index \>35
• •Patient requires an emergent procedure
• •Evidence of ongoing or active clinical instability, including acute chest pain (sudden onset), cardiogenic shock, unstable blood pressure with systolic blood pressure \<90 mmHg, and severe congestive heart failure (NYHA III or IV) or acute pulmonary edema
• •Any active, serious, life-threatening disease with a life expectancy of less than 2 months
• •Inability to comply with study procedures