Key result
Post-PCI angiography-based vessel fractional flow reserve demonstrated excellent diagnostic accuracy for predicting invasive FFR <0.90 (AUC 0.97; 95% CI 0.93-1.00).
Why the study?
The role of angiography-based vessel fractional flow reserve (vFFR) and its correlation with post-PCI FFR in chronic coronary occlusions had not yet been evaluated.
Does angiography-based vFFR accurately predict invasive FFR in patients after successful chronic coronary total occlusion recanalization?
Observational (n=50)
Does angiography-based vFFR accurately predict invasive FFR in patients after successful chronic coronary total occlusion recanalization?
Effect estimate: AUC 0.97 (95% CI 0.93-1.00)
Angiography-based vFFR demonstrates excellent diagnostic accuracy and strong correlation with invasive FFR for assessing physiological results after successful CTO PCI.
Post-PCI vFFR may substitute for invasive measurements after CTO recanalization; extends prior validation to this high-complexity subset.
BACKGROUND: Angiography-based vessel fractional flow reserve (vFFR) demonstrated a strong correlation with invasive fractional flow reserve (FFR) in both a pre- and post-percutaneous coronary intervention (PCI) setting. However, the role of vFFR and its correlation with post-PCI FFR in chronic coronary occlusions (CTO) has not been evaluated yet. We sought to investigate the diagnostic performance of post-PCI vFFR with post-PCI FFR as a reference in patients undergoing successful CTO PCI. METHODS: Between March 2016 and April 2020, a total of 80 patients from the FFR-SEARCH (prospective registry) and FFR REACT (randomized controlled trial) studies underwent successful CTO recanalization with post-PCI FFR measurements. RESULTS: A total of 50 patients (median age 66 (interquartile range [IQR]: 56-74) years, 76% were male) were eligible for the analysis. Median post-PCI FFR was 0.89 (IQR: 0.84-0.94), while median post-PCI vFFR was 0.91 (IQR: 0.85-0.94) (p 0.10). Suboptimal physiological results, defined as FFR and vFFR <0.90, were identified in 26 (52%) and in 21 (42%) patients, respectively. A strong correlation (r = 0.82) was found between vFFR and FFR with a mean bias of 0.013 ± 0.051. Receiver-operating characteristics curve analysis revealed an excellent accuracy of vFFR in predicting FFR <0.90 (area under the curve: 0.97; 95% confidence interval: 0.93-1.00). CONCLUSION: Post-PCI vFFR shows a good correlation with post-PCI FFR and a high diagnostic accuracy for post-PCI FFR ≤0.90 in patients undergoing successful PCI of a CTO lesion.
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Scoccia et al. (2022) conducted an observational in Chronic coronary total occlusion (CTO) (n=50). Angiography-based vessel fractional flow reserve (vFFR) vs. Invasive fractional flow reserve (FFR) was evaluated on Diagnostic accuracy for predicting FFR <0.90 (AUC 0.97, 95% CI 0.93-1.00). Post-PCI angiography-based vessel fractional flow reserve demonstrated excellent diagnostic accuracy for predicting invasive FFR <0.90 (AUC 0.97; 95% CI 0.93-1.00).
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