Author + information
- Yuhei Kobayashia,b,
- Nils Johnsona,b,
- Colin Berrya,b,
- Bernard De Bruynea,b,
- K. Lance Goulda,b,
- Allen Jeremiasa,b,
- Keith Oldroyda,b,
- Nico Pijlsa,b and
- William Fearona,b
Several adenosine-free coronary pressure wire indices have been proposed to assess the functional significance of coronary artery lesions; however, there is a theoretical concern that lesion location and the amount of myocardium interrogated may affect diagnostic performance.
In a total of 763 patients, fractional flow reserve (FFR) and contrast FFR (cFFR) were obtained during adenosine-induced maximal hyperemia and contrast-induced submaximal hyperemia, while instantaneous wave-free ratio (iFR) and distal/proximal coronary pressure ratio (Pd/Pa) were obtained at rest. Using FFR≤0.8 as a reference, the diagnostic accuracy of each index was compared based on lesion location (left main or proximal LAD compared to other locations).
The median FFR, cFFR, iFR, and Pd/Pa were 0.81, 0.86, 0.90, and 0.92. cFFR, iFR, and Pd/Pa were less accurate in left main or proximal LAD lesions compared to other lesions (cFFR: p=0.016, iFR: p=0.024, and Pd/Pa: p=0.059, Figure A). By receiver operator characteristics curve analysis, cFFR provided better diagnostic accuracy than resting indices irrespective of lesion location (p≤0.0001 for all, Figure B).
cFFR, iFR, and Pd/Pa are less accurate in left main or proximal LAD lesions compared to other locations, likely related to the larger amount of myocardium supplied by the left main and proximal LAD. Nevertheless, cFFR provides the best diagnostic accuracy among the adenosine-free indices, irrespective of lesion location.
Moderated Poster Contributions
ACC.i2 Interventional Cardiology Moderated Poster Theater, Poster Area, South Hall A1
Monday, April 04, 2016, 1:30 p.m.-1:40 p.m.
Session Title: ACC.i2 Coronary Intervention: Evidence to Practice
Abstract Category: 9. ACC.i2 Interventional Cardiology: IVUS and Intravascular Physiology
Presentation Number: 1287M-09
- 2016 American College of Cardiology Foundation