Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients
| Autor: | Doo Soo Jeon, Ki Jun Kim, Byung-Hee Hwang, Moo Jun Kim, Joo Myung Lee, Ik Jun Choi, Mi-Jeong Kim, Kiyuk Chang, Kwan Yong Lee, Ho-Joong Youn, Myeong-Ho Yoon, Wook Sung Chung, Chan Jun Kim, Eun-Ho Choo, Sang-wook Lee |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Science Myocardial Infarction Disease 030204 cardiovascular system & hematology Coronary Angiography Severity of Illness Index Article Angina Pectoris Angina Lesion Computational biophysics 03 medical and health sciences 0302 clinical medicine Ischemia Internal medicine medicine Humans In patient cardiovascular diseases 030212 general & internal medicine Myocardial infarction Aged Multidisciplinary medicine.diagnostic_test business.industry Coronary Stenosis Middle Aged Atherosclerosis medicine.disease Coronary Vessels Confidence interval Fractional Flow Reserve Myocardial Flow ratio Angiography Cardiology Medicine Female medicine.symptom business Interventional cardiology |
| Zdroj: | Scientific Reports Scientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
| ISSN: | 2045-2322 |
| DOI: | 10.1038/s41598-021-82235-y |
| Popis: | The quantitative flow ratio (QFR) is a novel angiography-based computational method assessing functional ischemia caused by coronary stenosis. This study aimed to evaluate the diagnostic performance of quantitative flow ratio (QFR) in patients with angina and acute myocardial infarction (AMI) and to identify the conditions with low diagnostic performance. We assessed the QFR for 1077 vessels under fractional flow ratio (FFR) evaluation in 915 patients with angina and AMI. The diagnostic accuracies of the QFR for identifying an FFR ≤ 0.8 were 95.98% (95% confidence interval [CI] 94.52 to 97.14%) for the angina group and 92.42% (95% CI 86.51 to 96.31%) for the AMI group. The diagnostic accuracy of the QFR in the borderline FFR zones (> 0.75, ≤ 0.85) (91.23% [95% CI 88.25 to 93.66%]) was significantly lower than that in others (difference: 4.32; p = 0.001). The condition accompanying both AMI and the borderline FFR zone showed the lowest QFR diagnostic accuracy in our data (83.93% [95% CI 71.67 to 92.38]). The diagnostic accuracy was reduced for tandem lesions (p = 0.04, not correcting for multiple testing). Our study found that the QFR method yielded a high overall diagnostic performance in real-world patients. However, low diagnostic accuracy has been observed in borderline FFR zones with AMI, and the hybrid FFR approach needs to be considered. |
| Databáze: | OpenAIRE |
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