PENGARUH PENGGUNAAN FFR-CT TERHADAP KEPUTUSAN KLINIS DAN OUTCOME PASIEN PENYAKIT JANTUNG KORONER: TINJAUAN LITERATUR
Abstract
Penyakit jantung koroner merupakan penyebab kematian utama secara global, sehingga diperlukan modalitas diagnostik yang akurat, aman, dan efisien dalam menentukan strategi penatalaksanaan. Fractional Flow Reserve berbasis Computed Tomography (CT-FFR) merupakan teknologi non-invasif yang menggabungkan informasi anatomi dan fungsional untuk menilai signifikansi hemodinamik stenosis koroner. Berdasarkan berbagai penelitian, penggunaan CT-FFR terbukti mampu mengurangi rujukan yang tidak perlu ke tindakan invasif Invasive Coronary Angiography (ICA) dan meningkatkan ketepatan seleksi pasien yang membutuhkan intervensi. Studi seperti ADVANCE Registry dan PLATFORM Trial menunjukkan penurunan signifikan pada prosedur ICA tanpa obstruksi bermakna serta pembatalan lebih dari separuh tindakan invasif yang sebelumnya direncanakan. Pada kasus penyakit koroner kompleks, CT-FFR juga berperan penting dalam mengubah rekomendasi klinis dan strategi revaskularisasi yang lebih tepat sasaran. Selain itu, nilai CT-FFR memiliki kemampuan prognostik, di mana pasien dengan nilai > 0,80 memiliki risiko major adverse cardiac events (MACE) yang sangat rendah, sementara nilai ≤ 0,80 berkaitan dengan peningkatan risiko MACE jangka panjang. Secara keseluruhan, CT-FFR berpotensi menjadi komponen penting dalam algoritma diagnostik modern untuk meningkatkan efisiensi klinis, akurasi penatalaksanaan, dan hasil akhir pasien dengan penyakit jantung koroner.
Keywords
Penyakit jantung koroner; Computed Tomography–Derived Fractional Flow Reserve; Computed Tomography Coronary Angiography; Invasive Coronary Angiography; revaskularisasi; Major Adverse Cardiac Events; diagnostik non-invasif
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