Resting full-cycle ratio (RFR) demonstrated a diagnostic accuracy of 78% compared to fractional flow reserve (FFR), with approximately 22% discordant results between the indices.
Cohort (n=617)
No
Does resting full-cycle ratio (RFR) accurately predict fractional flow reserve (FFR) ≤ 0.80 in patients with intermediate coronary lesions?
Resting full-cycle ratio (RFR) and other non-hyperemic pressure ratios show moderate diagnostic accuracy and good correlation with FFR, but yield discordant results in approximately 20% of cases in a real-world cohort.
Estimación del efecto: r = 0.766 (95% CI 75-81)
valor p: p=<0.01
Objective: The aim of this study was to evaluate non-hyperemic resting pressure ratios (NHPRs), especially the novel “resting full-cycle ratio” (RFR; lowest pressure distal to the stenosis/aortic pressure during the entire cardiac cycle), compared to the gold standard fractional flow reserve (FFR) in a “real-world” setting. Methods: The study included patients undergoing coronary pressure wire studies at one German University Hospital. No patients were excluded based on any baseline or procedural characteristics, except for insufficient quality of traces. The diagnostic performance of four NHPRs vs. FFR ≤ 0.80 was tested. Morphological characteristics of stenoses were analyzed by quantitative coronary angiography. Results: 617 patients with 712 coronary lesions were included. RFR showed a significant correlation with FFR ( r = 0.766, p 0.01). Diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of RFR were 78% (95% confidence interval = 75; 81), 72% (65; 78), 81% (77; 84), 63% (57; 69), and 86% (83; 89). Relevant predictors for discordance of RFR ≤ 0.89/FFR 0.8 were LAD lesions, peripheral artery disease, age, female sex and non-focal stenoses. Predictors for discordance of RFR 0.89/FFR ≤ 0.8 included non-LCX lesions, percent diameter stenosis and previous percutaneous coronary intervention in the target vessel. RFR and all other NHPRs were highly correlated with each other. Conclusion: All NHPRs have a similar correlation with the gold standard FFR and may facilitate the acceptance and implementation of physiological assessments of lesion severity. However, we found ~20% discordant results between NHPRs and FFR in our “all-comers” German cohort.
Wienemann et al. (Fri,) conducted a cohort in Coronary artery disease with intermediate coronary stenoses (n=617). Resting full-cycle ratio (RFR) vs. Fractional flow reserve (FFR) was evaluated on Diagnostic accuracy of RFR for predicting FFR ≤ 0.80 (r = 0.766, 95% CI 75-81, p=<0.01). Resting full-cycle ratio (RFR) demonstrated a diagnostic accuracy of 78% compared to fractional flow reserve (FFR), with approximately 22% discordant results between the indices.