1. Angiogram based fractional flow reserve in patients with dual/triple vessel coronary artery disease
- Author
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Toru Tanigaki, Munenori Okubo, Hiroyuki Omori, Hitoshi Matsuo, S. Okamoto, Yoshiaki Kawase, Ran Kornowski, Tetsuo Hirata, Guy Witberg, Hideaki Ota, Hiroki Kamiya, Orna Valzer, and Yoshihiro Sobue
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,Fractional flow reserve ,030204 cardiovascular system & hematology ,Coronary Angiography ,Revascularization ,Severity of Illness Index ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,In patient ,Prospective Studies ,030212 general & internal medicine ,Aged ,medicine.diagnostic_test ,business.industry ,Reproducibility of Results ,Percutaneous coronary intervention ,Multivessel disease ,medicine.disease ,Coronary Vessels ,Fractional Flow Reserve, Myocardial ,Conventional PCI ,Angiography ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
Objective To assess the performance of angiography derived Fractional Flow Reserve (FFRangio) in multivessel disease (MVD) patients undergoing angiography. Background FFR is the reference standard for physiologic assessment of coronary stenosis and guidance of revascularization, especially in patients with MVD, yet it remains grossly underutilized. The non-wire based FFRangio performs well in non-MVD patients, but its accuracy in MVD is unknown. Methods A prospective clinical study was conducted at Gifu Heart Centre, Japan. Patients underwent physiologic assessment of all relevant coronary lesions using wire-based FFR (wbFFR) and FFRangio. Primary outcome was diagnostic performance (sensitivity, specificity, accuracy) for FFRangio with wbFFR as reference. Other outcomes were the correlation between wbFFR/FFRangio, time required for wbFFR/FFRangio measurements, and the effect of wbFFR/FFRangio on the reclassification of coronary disease severity. Results Fifty patients (118 lesions in total) were included. Mean age was 72 ± 9 years, 72% were male, 36% had triple vessel disease and the average SYNTAX score was 13. The mean measurement of wbFFR and FFRangio were 0.83 ± 0.12 and 0.81 ± 0.11, respectively. Accuracy, sensitivity and specificity for FFRangio were 92.3% (95% CI 79.1–98.4%), 92.4% (95% CI 84.3–97.2%) and 92.4% (95% CI 87.4–97.3%), respectively. Pearson's r between wbFFR and FFRangio was 0.83. FFRangio measurement was faster than wbFFR (9.6 ± 3.4 vs. 15.0 ± 8.9 min, p Conclusions In patients with MVD, FFRangio shows good correlation and excellent diagnostic performance compared to wbFFR, and measuring FFRangio is faster than wbFFR. These results highlight the potential clinical benefits of utilizing FFRangio among patients with MVD.
- Published
- 2019
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