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Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients

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Abstract
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.
Author(s)
이상욱Byung-Hee HwangChan Jun KimDoo Soo JeonEun-Ho ChooHo-JoongYounIk Jun ChoiJoo Myung LeeKi Jun KimKiyuk ChangKwan Yong LeeMi-Jeong KimMoo Jun KimMyeong?HoYoonWook Sung Chung
Issued Date
2021
Type
Article
Keyword
LesionDiseaseQFR
DOI
10.1038/s41598-021-82235-y
URI
https://oak.ulsan.ac.kr/handle/2021.oak/6997
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_3bd91babd2eb425d9bf3a6ca17e3e790&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Influence%20of%20lesion%20and%20disease%20subsets%20on%20the%20diagnostic%20performance%20of%20the%20quantitative%20flow%20ratio%20in%20real-world%20patients&amp;offset=0&amp;pcAvailability=true
Publisher
SCIENTIFIC REPORTS
Location
독일
Language
영어
ISSN
2045-2322
Citation Volume
11
Citation Number
1
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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