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Impact of Diabetes on Management and Outcomes in Patients with Borderline FFRCT

Yanchun Chen1, Zhan Feng2, Wenjing Jia1

  • 1Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Rd, Chaoyang District, Beijing 100020, China.

Journal of Cardiovascular Development and Disease
|January 27, 2026
PubMed

Insights

Revascularization benefits patients with borderline CT-derived fractional flow reserve (FFRCT) by reducing major adverse cardiovascular events (MACE). This protective effect holds true for both diabetic and non-diabetic individuals, highlighting its importance in managing coronary artery disease.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Diabetes Research

Background:

  • The clinical significance of borderline CT-derived fractional flow reserve (FFRCT) values (0.70-0.80) in patients with suspected coronary artery disease is not fully understood.
  • The influence of diabetes on the management and outcomes of these patients remains unclear.

Purpose of the Study:

  • To investigate the impact of diabetes on the management and outcomes of patients with borderline FFRCT values.
  • To assess the relationship between revascularization and major adverse cardiovascular events (MACE) in this patient group, considering diabetes status.

Main Methods:

  • A multicenter study included 1515 symptomatic patients with suspected coronary artery disease and borderline FFRCT values (0.70-0.80) who underwent Coronary computed tomography angiography (CCTA).
  • Outcomes, including MACE (all-cause death, myocardial infarction, unplanned revascularization), were analyzed using Cox proportional hazards models and restricted cubic spline analysis (RCS).
  • Revascularization within 90 days of CCTA was documented.

Main Results:

  • The study included 503 diabetic patients (33.2%) and 1012 non-diabetic patients.
  • Over a median follow-up of 985 days, 117 MACE occurred.
  • Revascularization was independently associated with a reduced risk of MACE in both diabetic (aHR 0.25) and non-diabetic patients (aHR 0.53).
  • RCS analysis revealed a significant non-linear relationship between FFRCT and MACE in non-diabetic patients.

Conclusions:

  • In patients with borderline FFRCT, revascularization is associated with a lower incidence of MACE.
  • This beneficial association of revascularization was consistent across both diabetic and non-diabetic patient groups.

Keywords:
FFRCTICAMACEdiabetesrevascularization

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