Head-to-head comparison of basal stenosis resistance index, instantaneous wave-free ratio, and fractional flow reserve: diagnostic accuracy for stenosis-specific myocardial ischaemia
| Autor: | Hein J. Verberne, de Winter Rj, S Nijjer, Karel T. Koch, M. Meuwissen, Steven A. J. Chamuleau, van Eck-Smit Bl, Jan J. Piek, Michiel Voskuil, José P.S. Henriques, Mauro Echavarria-Pinto, Ricardo Petraco, Maria Siebes, Froukje Nolte, van Lavieren Ma, Javier Escaned, Sayan Sen, Justin E. Davies, van de Hoef Tp, J. G. P. Tijssen, J. A. E. Spaan |
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| Přispěvatelé: | Cardiology, Graduate School, Other departments, ACS - Amsterdam Cardiovascular Sciences, Nuclear Medicine, Biomedical Engineering and Physics |
| Rok vydání: | 2015 |
| Předmět: |
Male
Cardiac Catheterization Myocardial ischaemia medicine.medical_specialty Adenosine Head to head Vasodilator Agents Hyperemia Diagnostic accuracy Fractional flow reserve Severity of Illness Index Basal (phylogenetics) Predictive Value of Tests Internal medicine Humans Medicine Instantaneous wave-free ratio Aged Receiver operating characteristic business.industry Coronary Stenosis Myocardial Perfusion Imaging Discriminant Analysis Reproducibility of Results Middle Aged medicine.disease Surgery Fractional Flow Reserve Myocardial Stenosis ROC Curve Area Under Curve Cardiology Female Vascular Resistance Cardiology and Cardiovascular Medicine business |
| Zdroj: | EuroIntervention, 11(8), 914-925. EuroPCR Scopus-Elsevier |
| ISSN: | 1774-024X |
| Popis: | AIMS We sought to compare the diagnostic accuracy of basal stenosis resistance index (BSR), instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) for stenosis-specific myocardial ischaemia identified by means of a combined reference standard of myocardial perfusion scintigraphy and the hyperaemic stenosis resistance index. METHODS AND RESULTS BSR and FFR were determined for 299 coronary stenoses, iFR was determined for 85 coronary stenoses (iFR cohort). The discriminative value for stenosis-specific myocardial ischaemia was compared by means of the area under the receiver operating characteristic (ROC) curves (AUC). Classification agreement with the reference standard was determined according to ROC curve-derived ischaemic cut-off values, as well as according to clinical cut-off values, equivalent to the 0.80 FFR cut-off. Across all stenoses, the discriminative value of BSR and FFR was equivalent (AUC: 0.90 and 0.91, respectively, p=0.46). In the iFR cohort, the discriminative value was equivalent for BSR, iFR, and FFR (AUC: 0.88, 0.84, and 0.88, respectively; p≥0.20 for all). At both ischaemic as well as clinical cut-off values, classification agreement with the reference standard was equivalent for BSR and FFR across all stenoses, as well as for BSR, iFR, and FFR in the iFR cohort. CONCLUSIONS BSR, iFR, and FFR have equivalent diagnostic accuracy for the detection of ischaemia-generating coronary stenoses. |
| Databáze: | OpenAIRE |
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