Key result
ΔFFR accurately predicts coronary ischemic lesions with ~0.95 AUC alongside baseline FFR.
Why the study?
The decrease in FFR after adenosine administration (ΔFFR) may reflect microvascular compensatory capacity, and whether baseline FFR and ΔFFR can identify coronary ischemic lesions and their severity required investigation.
Does baseline FFR and ΔFFR accurately predict functionally significant coronary ischemic lesions in patients with intermediate coronary stenosis?
Cross-Sectional (n=154)
Yes
Does baseline FFR and ΔFFR accurately predict functionally significant coronary ischemic lesions in patients with intermediate coronary stenosis?
Effect estimate: AUC 0.946 (95% CI 0.913-0.980)
Absolute Event Rate: 0.946% vs 0.933%
p-value: p=<0.001
Both baseline FFR and ΔFFR demonstrate high diagnostic accuracy for predicting functionally significant coronary ischemic lesions in patients with intermediate stenosis.
Baseline FFR and ΔFFR may aid lesion assessment in intermediate stenosis; hypothesis-generating and requires prospective validation before practice change.
Background: The decrease in fractional flow reserve (FFR) after adenosine administration from baseline FFR value (termed as ΔFFR) may reflect the compensatory capacity of the microvascular circulation and thus may predict significant coronary stenotic lesions. We aimed to investigate whether baseline FFR and ΔFFR can help identify the coronary ischemic lesion and its severity. Materials and Methods: This cross-sectional study was performed on 154 consecutive patients (Mean age 62.42 ± 9.36 years) that underwent coronary angiography and with definitive intermediate coronary lesions at any of the coronary vessels. FFR was calculated by dividing the mean distal intracoronary pressure by the mean arterial pressure. ΔFFR was also defined as the difference between baseline FFR and hyperemic FFR (considering FFR<0.75 as the criteria for ischemia). Results: The area under receiver-operating characteristic curve for baseline FFR was found as 0.933, and for ΔFFR was 0.946 indicated high values of both indices for predicting ischemic lesions. The best cut-off point for baseline FFR and ΔFFR for discriminating ischemic lesions from the normal condition was 89.5 (yielding a sensitivity of 92.2% and a specificity of 68.0%) and 9.5 (yielding a sensitivity of 96.0% and a specificity of 85.3%), respectively. Conclusion: Our study could successfully demonstrate the high value of both baseline FFR and ΔFFR for predicting coronary ischemic lesions with the cut-off values of <89.5 and >9.5, respectively. [GMJ.2020;9:e1528]
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Eftekharzadeh et al. (2020) conducted a cross-sectional in Coronary Ischemic Lesions (n=154). Delta Fractional Flow Reserve (ΔFFR) vs. Baseline FFR was evaluated on Area under the receiver-operating characteristic (ROC) curve for predicting ischemic lesions (hyperemic FFR < 0.75) (AUC 0.946, 95% CI 0.913-0.980, p=<0.001). Delta fractional flow reserve (ΔFFR) accurately predicted coronary ischemic lesions with an area under the curve of 0.946, demonstrating high diagnostic value alongside baseline FFR.
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