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Diagnostic performance of angiography-based fractional flow reserve by patient and lesion characteristics: Report from the FAST-FFR Study

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  • Yuhei Kobayashi
  • Carlos Collet
  • Stephan Achenbach
  • Thomas Engstrøm
  • Abid Assali
  • Richard A Shlofmitz
  • Stephane Fournier
  • Ajay J Kirtane
  • Ziad A Ali
  • Ran Kornowski
  • Martin B Leon
  • Bernard De Bruyne
  • William F Fearon
  • Collaborators
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BACKGROUND: A large, prospective, multicentre trial recently showed that fractional flow reserve (FFR) derived from coronary angiography (FFRangio) has an accuracy of 92% compared with conventional guidewire-based FFR (FFRwire); however, little is known about whether specific patient/lesion characteristics affect the diagnostic performance.

AIMS: The primary goal of the present study was to investigate whether specific patient or lesion characteristics such as high body mass index (BMI), presentation with an acute coronary syndrome, or lesion location affect the diagnostic performance of FFRangio in patients enrolled in the FAST-FFR study.

METHODS: FFRangio was measured in a blinded fashion in 301 patients (319 vessels) who were undergoing FFRwire assessment. Using an FFRwire ≤0.80 as a reference, the diagnostic performance of FFRangio was compared in pre-specified subgroups.

RESULTS: The mean FFRwire and FFRangio were 0.81±0.13 and 0.80±0.12. Overall, FFRangio had a sensitivity of 93.5% and specificity of 91.2% for predicting FFRwire. Patient characteristics including age, sex, clinical presentation, body mass index, and diabetes did not affect sensitivity or specificity (p>0.05 for all). Similarly, lesion characteristics including calcification and tortuosity did not affect sensitivity or specificity (p>0.05 for all), nor did lesion location (proximal, middle, versus distal). Sensitivity was equally high across all target vessels, while specificity was highest in the LAD and lower (~85%) in the RCA and LCx (p<0.05).

CONCLUSIONS: FFRangio derived from coronary angiography has a high diagnostic performance regardless of patient and most lesion characteristics. The interaction of vessel on the specificity will need to be confirmed in larger cohorts.

Original languageEnglish
JournalEuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
Volume17
Issue number4
Pages (from-to)e294-e300
ISSN1774-024X
DOIs
Publication statusPublished - 20 Jul 2021

    Research areas

  • Coronary Angiography, Coronary Artery Disease/diagnostic imaging, Coronary Stenosis/diagnostic imaging, Fractional Flow Reserve, Myocardial, Humans, Predictive Value of Tests, Prospective Studies, Severity of Illness Index, stable angina, fractional flow reserve, QCA, Stable angina, Fractional flow reserve

ID: 62333124