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Diagnostic Performance of Angiography-based Fractional Flow Reserve in Various Subgroups: Report from the FAST-FFR Study

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@article{5ecb8bc40e234e8b9a409ef8a5ee300d,
title = "Diagnostic Performance of Angiography-based Fractional Flow Reserve in Various Subgroups: Report from the FAST-FFR Study",
abstract = "AIMS: A large, prospective, multicenter trial recently showed that fractional flow reserve (FFR) derived from coronary angiography (FFRangio) has an accuracy of 92% compared with conventional guide-wire based FFR (FFRwire); however, little is known whether specific patient/lesion characteristics affect the diagnostic performance.METHODS AND RESULTS: 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. 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, 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.",
author = "Yuhei Kobayashi and Carlos Collet and Stephan Achenbach and Thomas Engstr{\o}m and Abid Assali and Shlofmitz, {Richard A} and Stephane Fournier and Kirtane, {Ajay J} and Ali, {Ziad A} and Ran Kornowski and Leon, {Martin B} and {De Bruyne}, Bernard and Fearon, {William F} and Collaborators",
year = "2021",
doi = "10.4244/EIJ-D-19-00933",
language = "English",
journal = "EuroIntervention",
issn = "1774-024X",
publisher = "Europa Edition",

}

RIS

TY - JOUR

T1 - Diagnostic Performance of Angiography-based Fractional Flow Reserve in Various Subgroups

T2 - Report from the FAST-FFR Study

AU - Kobayashi, Yuhei

AU - Collet, Carlos

AU - Achenbach, Stephan

AU - Engstrøm, Thomas

AU - Assali, Abid

AU - Shlofmitz, Richard A

AU - Fournier, Stephane

AU - Kirtane, Ajay J

AU - Ali, Ziad A

AU - Kornowski, Ran

AU - Leon, Martin B

AU - De Bruyne, Bernard

AU - Fearon, William F

AU - Collaborators

PY - 2021

Y1 - 2021

N2 - AIMS: A large, prospective, multicenter trial recently showed that fractional flow reserve (FFR) derived from coronary angiography (FFRangio) has an accuracy of 92% compared with conventional guide-wire based FFR (FFRwire); however, little is known whether specific patient/lesion characteristics affect the diagnostic performance.METHODS AND RESULTS: 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. 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, 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.

AB - AIMS: A large, prospective, multicenter trial recently showed that fractional flow reserve (FFR) derived from coronary angiography (FFRangio) has an accuracy of 92% compared with conventional guide-wire based FFR (FFRwire); however, little is known whether specific patient/lesion characteristics affect the diagnostic performance.METHODS AND RESULTS: 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. 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, 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.

U2 - 10.4244/EIJ-D-19-00933

DO - 10.4244/EIJ-D-19-00933

M3 - Journal article

C2 - 32364503

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

ER -

ID: 62333124