Diagnostic Accuracy of Computational Fluid Dynamics‐Based Fractional Flow Reserve Derived From Coronary Angiography: The ACCURATE Study

Q: What are the key findings of this study?

AccuFFRangio derived from coronary angiography alone demonstrated high diagnostic accuracy compared with FFR, yielding an area under the curve of 0.972 (95% CI 0.947-0.988).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hemodynamically significant coronary stenosis. Intervention: AccuFFRangio vs. Fractional flow reserve (FFR). Primary outcome: Diagnostic accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) (AUC 0.972, 95% CI 0.947-0.988, p=<0.001).

Q: What question did this study set out to answer?

To assess the feasibility and diagnostic performance of an angiography-derived fractional flow reserve modality based on computational fluid dynamics (AccuFFRangio) for coronary physiological assessment.

Jun Jiang; Yumeng Hu; Changling Li; Liang Dong; Jian Xu; Lijiang Tang; Wenbing Jiang; Changqing Du; Xuejun Jiang; Yongnan Lyu; Xiaochang Leng; Chengguang Li; Bon‐Kwon Koo; Jianping Xiang; Junbo Ge; Jianan Wang

doi:10.1161/jaha.124.035672

December 25, 2024SHILAP Revista de lepidopterologíaOpen Access

Diagnostic Accuracy of Computational Fluid Dynamics‐Based Fractional Flow Reserve Derived From Coronary Angiography: The ACCURATE Study

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Key result

Angiography-derived AccuFFRangio shows high diagnostic accuracy vs. wire-based FFR with an AUC of ~0.97.

AUC 0.972
95% CI 0.947-0.988
P<0.001

Why the study?

Does AccuFFRangio accurately detect hemodynamically significant coronary stenosis compared to invasive FFR?

Key Points

To assess the feasibility and diagnostic performance of an angiography-derived fractional flow reserve modality based on computational fluid dynamics (AccuFFRangio) for coronary physiological assessment.
Evaluated the diagnostic performance of angiography-derived fractional flow reserve (AccuFFRangio) compared against standard wire-based fractional flow reserve (NCT04814550).
Achieved a diagnostic sensitivity of 95.83% (95% CI, 89.67%–98.85%) and a specificity of 94.71% (95% CI, 90.73%–97.33%) compared with standard fractional flow reserve.
Demonstrated an area under the receiver operating characteristic curve of 0.972 (95% CI, 0.947–0.988; P < 0.001).

Study Design

Type

Cross-Sectional

Structured PICO

Does AccuFFRangio accurately detect hemodynamically significant coronary stenosis compared to invasive FFR?

P

Population

Patients requiring functional assessment of coronary artery stenosis

E

Exposure

Computational fluid dynamics-based fractional flow reserve derived from invasive coronary angiography (AccuFFRangio)

C

Comparator

Invasive wire-based fractional flow reserve (FFR)

O

Outcome

Diagnostic accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve)surrogate

Main Result

Effect estimate: AUC 0.972 (95% CI 0.947-0.988)

p-value: p=<0.001

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Implication

AccuFFRangio demonstrates high diagnostic accuracy compared to invasive FFR, offering a potential wire-free alternative for the physiological assessment of coronary stenosis.

Abstract

BACKGROUND: Although fractional flow reserve (FFR) is the contemporary standard to detect hemodynamically significant coronary stenosis, it remains underused for the need of pressure wire and hyperemic stimulus. Coronary angiography-derived FFR could break through these barriers. The aim of this study was to assess the feasibility and performance of a novel diagnostic modality deriving FFR from invasive coronary angiography (AccuFFRangio) for coronary physiological assessment. METHODS AND The sensitivity, specificity, and area under the receiver operating characteristic curve of 95.83% (95% CI, 89.67%-98.85%), 94.71% (95% CI, 90.73%-97.33%), and 0.972 (95% CI, 0.947-0.988), respectively. CONCLUSIONS: AccuFFRangio derived from coronary angiography alone has high diagnostic accuracy, sensitivity, and specificity compared with FFR. AccuFFRangio bears the potential for increasing the adoption of functional assessment of coronary artery stenosis and improving the use of physiological guided decision-making. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04814550.

Discussion

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Cite This Study

Jiang et al. (2024) conducted a cross-sectional in Hemodynamically significant coronary stenosis. AccuFFRangio vs. Fractional flow reserve (FFR) was evaluated on Diagnostic accuracy (sensitivity, specificity, and area under the receiver operating characteristic curve) (AUC 0.972, 95% CI 0.947-0.988, p=<0.001). AccuFFRangio derived from coronary angiography alone demonstrated high diagnostic accuracy compared with FFR, yielding an area under the curve of 0.972 (95% CI 0.947-0.988).

synapsesocial.com/papers/69f3ee1fdc238f81977995f9 https://doi.org/10.1161/jaha.124.035672

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Diagnostic Accuracy of Computational Fluid Dynamics‐Based Fractional Flow Reserve Derived From Coronary Angiography: The ACCURATE Study

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Diagnostic Accuracy of Computational Fluid Dynamics‐Based Fractional Flow Reserve Derived From Coronary Angiography: The ACCURATE Study

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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