Finizio M, Melaku GD, Kahsay Y, Beyene S, Kuku KO, Ben-Dor I, Hashim H, Waksman R, Garcia-Garcia HM. Comparison of quantitative flow ratio and invasive physiology indices in a diverse population at a tertiary United States hospital.
CARDIOVASCULAR REVASCULARIZATION MEDICINE 2021;
32:1-4. [PMID:
34215559 DOI:
10.1016/j.carrev.2021.06.115]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND
Quantitative flow ratio (QFR) is a technology to evaluate the coronary stenosis significance on 3-dimensional quantitative coronary angiography. The aim of this study is to evaluate and compare the QFR versus fractional flow reserve (FFR) and/or instantaneous free-wave ratio (iFR) in a US population with a fair African American population representation.
METHODS AND RESULTS
This was a retrospective, observational and single center study which enrolled 100 patients who underwent coronary angiography. The diagnostic performance of QFR in terms of sensitivity was 0.80 (95%CI 0.64-0.97) and specificity was 0.95 (95%CI 0.90-1.00), the positive predictive value (PPV) was 0.83 (0.68-0.98), while the NPV was 0.94 (0.88-0.99). The overall accuracy was 0.91 and area under curve (AUC) was 0.92 (95% CI 0.87-0.97). The R-squared was 0.54 and the Bland-Altman plot showed a bias of 0.0016 (SD 0.063) and limits of agreement (LOA): Upper LOA 0.13 and Lower LOA -0.12. In African Americans (n = 33), accuracy, AUC, sensitivity, specificity (94%; 0.90 (0.80-1.00); 0.90 (0.71-1.00); 0.96 (0.87-1.00), respectively) were better than those for the overall population.
CONCLUSIONS
In a US based representative population, vessel QFR accuracy and agreement with FFR as reference is high. Diagnostic performance of QFR in African Americans is also excellent.
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