Comparative Analysis of vFFR and FFR Wire: Data From the Réunion Registry

Objectives Assessing fractional flow reserve (FFR) with a pressure wire is frequently underused due to the invasiveness of guide wire insertion and the necessity for a hyperemic agent. This study aimed to assess the diagnostic accuracy of the CAAS‐vessel FFR (vFFR) software tool compared to pressure wire (pw) FFR in evaluating coronary stenotic lesions. Methods A single‐center, prospective study was conducted at Clinique Saint Clotilde, Reunion Island, from August 2023 to March 2024. All patients undergoing coronary angiograms with pwFFR assessment of lesion severity of 40%–70% were included. Diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of vFFR were calculated using pwFFR as the reference standard. The cutoff value of 0.80 was used for both modalities. Results A total of 116 patients with 146 lesions were included. The mean age was 67 ± 9 years old, with 19% being female. Patients had an average of 1.3 ± 0.4 lesions each, with a mean pwFFR of 0.79 ± 0.09 and a mean vFFR of 0.79 ± 0.28. The overall diagnostic accuracy of vFFR was 77%, with sensitivity/specificity of 85%/71% and PPV/NPV of 67%/87%. For the left anterior descending coronary artery, the accuracy was 78%, with a sensitivity/specificity of 81%/78%. In the grey zone (invasive FFR 0.75–0.85), the accuracy dropped to 70%. Conclusion vFFR is a reliable noninvasive alternative to pwFFR, showing acceptable diagnostic accuracy in line with current literature.