Angiography-Derived Fractional Flow Reserve in the SYNTAX II Trial: Feasibility, Diagnostic Performance of Quantitative Flow Ratio, and Clinical Prognostic Value of Functional SYNTAX Score Derived From Quantitative Flow Ratio in Patients With 3-Vessel Disease.

Aged Cardiac Catheterization Clinical Trials as Topic Coronary Angiography Coronary Artery Bypass / adverse effects Coronary Artery Disease / diagnostic imaging Coronary Stenosis / diagnostic imaging Coronary Vessels / diagnostic imaging Drug-Eluting Stents Feasibility Studies Female Fractional Flow Reserve, Myocardial Humans Male Middle Aged Percutaneous Coronary Intervention / adverse effects Predictive Value of Tests Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome

3-vessel disease functional SYNTAX score quantitative flow ratio

Journal

JACC. Cardiovascular interventions

ISSN: 1876-7605

Titre abrégé: JACC Cardiovasc Interv

Pays: United States

ID NLM: 101467004

Informations de publication

Date de publication:
11 02 2019

Historique:

received: 11 06 2018

revised: 03 09 2018

accepted: 17 09 2018

pubmed: 10 11 2018

medline: 26 3 2020

entrez: 10 11 2018

Statut: ppublish

Résumé

The aims of the present study were to investigate the applicability of quantitative flow ratio (QFR) in patients with 3-vessel disease and to demonstrate the impact of functional SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) score derived from QFR (fSS The applicability of QFR in patients with 3-vessel disease and the feasibility of fSS All lesions interrogated using instantaneous wave-free ratio and/or fractional flow reserve in the SYNTAX II trial were retrospectively screened and analyzed for QFR. The diagnostic performance of QFR was investigated using hybrid wire-derived pressure assessment (instantaneous wave-free ratio and fractional flow reserve), used in the trial as a reference. Patients with analyzable QFR in 3 vessels were stratified according to fSS QFRs were analyzable in 71.0% of lesions (836 lesions). The diagnostic performance of QFR to predict binary wire-based ischemia was substantial (area under the curve 0.81, accuracy 73.8%), with a positive predictive value of 85.9%. Independent predictors of diagnostic discordance were lesions in side branches, involvement of bifurcation or trifurcation, and small vessel. According to the 2-year patient-oriented composite endpoint, fSS QFR demonstrated substantial applicability in patients with 3-vessel disease. The fSS

Sections du résumé

OBJECTIVES

BACKGROUND

The applicability of QFR in patients with 3-vessel disease and the feasibility of fSS

METHODS

All lesions interrogated using instantaneous wave-free ratio and/or fractional flow reserve in the SYNTAX II trial were retrospectively screened and analyzed for QFR. The diagnostic performance of QFR was investigated using hybrid wire-derived pressure assessment (instantaneous wave-free ratio and fractional flow reserve), used in the trial as a reference. Patients with analyzable QFR in 3 vessels were stratified according to fSS

RESULTS

QFRs were analyzable in 71.0% of lesions (836 lesions). The diagnostic performance of QFR to predict binary wire-based ischemia was substantial (area under the curve 0.81, accuracy 73.8%), with a positive predictive value of 85.9%. Independent predictors of diagnostic discordance were lesions in side branches, involvement of bifurcation or trifurcation, and small vessel. According to the 2-year patient-oriented composite endpoint, fSS

CONCLUSIONS

QFR demonstrated substantial applicability in patients with 3-vessel disease. The fSS

Identifiants

DOI: 10.1016/j.jcin.2018.09.023 PMID: 30409759

pubmed: 30409759

pii: S1936-8798(18)31945-9

doi: 10.1016/j.jcin.2018.09.023

pii:

doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

Pagination

259-270

Commentaires et corrections

Type : CommentIn