Article ; Online: Diagnostic performance of quantitative flow ratio in non-ST elevation acute coronary syndromes in comparison to non-hyperemic pressure ratios: a prospective study.
The international journal of cardiovascular imaging
2023 Volume 39, Issue 12, Page(s) 2567–2574
Abstract: Quantitative flow ratio (QFR) is a new angiography-based coronary physiology tool aimed to evaluate functional relevance of intermediate coronary lesions. Aim of the study is to assess diagnostic performance of QFR in patients with non-ST-elevation acute ...
| Abstract | Quantitative flow ratio (QFR) is a new angiography-based coronary physiology tool aimed to evaluate functional relevance of intermediate coronary lesions. Aim of the study is to assess diagnostic performance of QFR in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) in comparison to currently used non-hyperaemic pressure ratios (NHPRs). In this prospective, single-centre study, coronary physiology of intermediate coronary stenoses of non-culprit vessels in patients presenting with NSTE-ACS was evaluated using NHPRs (iFR, DFR or RFR). Subsequently, QFR was computed offline by a QFR analyst blinded to the NHPR results. Diagnostic performance of QFR was assessed in comparison to NHPRs as reference standard. A total of 60 vessels with intermediate coronary stenoses was investigated. The NHPRs were used as follows: RFR 38%, DFR 47% and iFR 15% of the cases. The NHPR result was positive, showing significant lesion, in 19 cases. A significant correlation was found between NHPR and QFR (r = 0.84, p < 0.001). Classification agreement of the two methods (95%) and diagnostic performance of QFR in comparison to NHPR (AUC: 0.962 [0.914-1.00]) were both high. Sensitivity, specificity, positive and negative predictive value of QFR in comparison to NHPR were 84.2%, 100%, 100% and 93.2% respectively. QFR has high diagnostic performance in detecting functionally significant lesions of non-culprit arteries in patients with NSTE-ACS and multivessel disease. Due to its high negative predictive value, it can be used to safely avoid unnecessary invasive physiological assessment of these lesions. |
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| MeSH term(s) | Humans ; Prospective Studies ; Acute Coronary Syndrome/diagnostic imaging ; Acute Coronary Syndrome/therapy ; Coronary Angiography/methods ; Fractional Flow Reserve, Myocardial/physiology ; Coronary Vessels/diagnostic imaging ; Predictive Value of Tests ; Coronary Stenosis/diagnostic imaging ; Coronary Stenosis/therapy ; Severity of Illness Index ; Coronary Artery Disease | |||||
| Language | English | |||||
| Publishing date | 2023-10-26 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 2055311-0 | |||||
| ISSN | 1875-8312 ; 1573-0743 ; 1569-5794 ; 0167-9899 | |||||
| ISSN (online) | 1875-8312 ; 1573-0743 | |||||
| ISSN | 1569-5794 ; 0167-9899 | |||||
| DOI | 10.1007/s10554-023-02967-y | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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