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Advanced CT Test Simulates Blood Flow to Assess Risk in Patients with Angina

By MedImaging International staff writers
Posted on 13 Sep 2023

Coronary artery calcium is considered as a surrogate marker for total coronary plaque, a fatty buildup in the arteries that can result in a heart attack in the future. A calcium score above 400 is a warning sign of high plaque levels. Non-contrast enhanced cardiac CT is typically performed prior to CT angiography to determine the amount of coronary artery calcium. However, high calcium content can interfere with CT images, making them tough to evaluate. While CT angiography helps identify coronary artery disease, it does not reveal how this condition impacts blood flow. Disrupted blood flow can create abnormal pressure, making these plaques more likely to break open. Now, an advanced CT test can identify individuals with stable angina who are at a reduced risk for negative outcomes over three years, even if their calcium scores are high.

In a prospective study, researchers from the University Hospital of Southern Denmark (Esbjerg, Denmark) looked at the three-year clinical results of patients who went through CT angiography and another specialized scan known as CT angiography-derived fractional flow reserve (CT-FFR). This advanced test combines CT images, AI algorithms, and fluid dynamics calculations to mimic the blood flow in the coronary arteries. The study involved patients newly diagnosed with stable coronary artery disease, who were part of the ADVANCE clinical trial conducted between December 2015 and October 2017 across three locations in Denmark. To be part of this study, patients needed to have at least one coronary artery narrowed by more than 30% and must not have had a history of irregular heartbeats or previous procedures to improve heart blood flow.

Out of 900 participants, 523 had normal CT-FFR results (average age 64, 318 males) and 377 showed abnormal CT-FFR findings (average age 65, 264 males). The three-year adverse outcome rate, which includes death from any cause and non-fatal heart attacks, was just 2.1% (11 out of 523) in the normal CT-FFR group. On the other hand, this rate was 6.6% (25 out of 377) in the abnormal CT-FFR group. Interestingly, those with a high calcium score but normal CT-FFR results had a 2.2% (4 out of 182) adverse outcome rate over three years. The rate soared to 9% (19 out of 212) for those with both high calcium scores and abnormal CT-FFR results. According to the team, while there are various methods to study the effects of coronary artery disease on blood flow, CT-FFR stands out for its high diagnostic accuracy. It aligns well with fractional flow reserve, a more invasive measurement method. The researchers believe that CT-FFR could help doctors categorize patients by risk level and focus on improving the outlook for those at higher risk.

“Our study provides evidence for the prognostic potential of CT-FFR in patients with high coronary artery calcium scores,” said lead researcher Kristian T. Madsen, M.D. “Regardless of the patient’s baseline risk and extent of coronary artery disease measured by coronary artery calcium, if CT-FFR results are normal, the prognosis is good.”

“In my opinion, CT-FFR is the best option because it provides a blood-flow estimate similar to what you would obtain if you performed invasive heart catheterization. You get a reliable and quick answer without performing additional tests or putting the patient through an invasive procedure,” added Madsen. “CT-FFR provides diagnostic and prognostic information beyond what can be obtained from CT angiography alone across a wide range of coronary artery calcium levels. It’s a tool that offers a lot of exciting prospects for the future.”

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60 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

61 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

62 (239.13383483887): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

63 (!!!!! 1271.9631195068): SELECT fid FROM jos_deeppockets WHERE id=294798615 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294798615 AND published='1' LIMIT 1

64 (!!!!! 1183.032989502): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

65 (!!!!! 1927.8526306152): select jos_twitters.link from jos_twitters where cat=10

66 (255.10787963867): select jos_facebook.link from jos_facebook where cat=10

67 (35.762786865234): select jos_google_plus.link from jos_google_plus where cat=10

68 (27.179718017578): select jos_linkedin.link from jos_linkedin where cat=10

69 (43.869018554688): SELECT fid FROM jos_deeppockets WHERE id=294798615 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294798615 AND published='1' LIMIT 1

70 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

71 (223.87504577637): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (602.00691223145): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (!!!!! 4281.9976806641): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

74 (508.06999206543): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (258.9225769043): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 1548.0518341064): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (162.12463378906): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (171.18453979492): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (149.96528625488): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (133.99124145508): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (116.10984802246): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (123.97766113281): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (124.93133544922): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (144.00482177734): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (128.98445129395): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (190.01960754395): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (257.01522827148): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (282.04917907715): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

91 (!!!!! 3902.9121398926): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (260.1146697998): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (138.99803161621): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (189.06593322754): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (116.10984802246): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (113.01040649414): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (210.04676818848): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (125.16975402832): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (698.80485534668): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

106 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

107 (459.90943908691): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798615 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (49.829483032227): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798615 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (205.99365234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

110 (142.81272888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

111 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798615 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (355.00526428223): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798615 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (663.04206848145): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 2143.1446075439): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

115 (225.06713867188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

116 (905.03692626953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

117 (179.05235290527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

118 (!!!!! 3367.1855926514): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

119 (94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

120 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

121 (300.88424682617): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

122 (!!!!! 192739.00985718): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

123 (485.89706420898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

124 (!!!!! 1420.0210571289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

125 (!!!!! 5650.9971618652): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798615 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798615 AND type='deeppockets_item' AND published='1' LIMIT 1

126 (!!!!! 1764117.9561615): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (!!!!! 2425779.1042328): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

128 (!!!!! 4667.9973602295): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (!!!!! 5466.9380187988): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

130 (!!!!! 15699.148178101): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (!!!!! 5522.0127105713): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

132 (!!!!! 2727.9853820801): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (!!!!! 11706.829071045): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

134 (379.08554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (348.80638122559): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (121.11663818359): SELECT name FROM jos_deeppockets WHERE id=215

137 (82.015991210938): SELECT name FROM jos_deeppockets WHERE id=215

138 (437.97492980957): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (467.77725219727): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (!!!!! 1254.7969818115): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

141 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

142 (!!!!! 17746.925354004): TRUNCATE TABLE jos_trademed_module

143 (!!!!! 4606.0085296631): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798615 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 3949.1653442383): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798615 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (413.89465332031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (68.187713623047): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

148 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

149 (!!!!! 1204.9674987793): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

150 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

151 (!!!!! 2331.018447876): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

152 (424.86190795898): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798615 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798615 AND type='deeppockets_item' AND published='1' LIMIT 1

153 (61.03515625): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (28.848648071289): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

155 (30.040740966797): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

156 (154.97207641602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

157 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798615 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798615 AND published='1' LIMIT 1

158 (68.187713623047): select jos_twitters.link from jos_twitters where cat=10

159 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

160 (27.179718017578): select jos_google_plus.link from jos_google_plus where cat=10

161 (26.941299438477): select jos_linkedin.link from jos_linkedin where cat=10

162 (282.04917907715): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

163 (!!!!! 1441.0018920898): insert into jos_banners_delta values (14615,'2025-04-30 02:40:19','52.14.236.216','view'),(14202,'2025-04-30 02:40:19','52.14.236.216','view'),(14203,'2025-04-30 02:40:19','52.14.236.216','view')

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