Key result
cFFR and QFR accurately assess coronary stenosis severity versus FFR with ~87% pooled sensitivity.
Why the study?
FFR utility is limited by cost, procedure time, and adenosine side effects, but adenosine-free indices like cFFR and QFR can simplify functional coronary stenosis assessment.
Do cFFR and QFR provide comparable diagnostic performance to FFR for the functional assessment of coronary stenoses?
Meta-Analysis
Do cFFR and QFR provide comparable diagnostic performance to FFR for the functional assessment of coronary stenoses?
Effect estimate: Sensitivity 0.87 (95% CI 0.81-0.91)
p-value: p=0.8406
Both cFFR and QFR demonstrate excellent and comparable diagnostic performance to FFR for assessing coronary stenosis severity, offering potential adenosine-free alternatives.
Supports cFFR/QFR as adenosine-free FFR alternatives; confirms comparable diagnostic accuracy in meta-analysis.
Background. Use of the fractional flow reserve (FFR) technique is recommended to evaluate coronary stenosis severity and guide revascularization. However, its high cost, time to administer, and the side effects of adenosine reduce its clinical utility. Two novel adenosine-free indices, contrast-FFR (cFFR) and quantitative flow ratio (QFR), can simplify the functional evaluation of coronary stenosis. This study aimed to analyze the diagnostic performance of cFFR and QFR using FFR as a reference index. Methods. We conducted a systematic review and meta-analysis of observational studies in which cFFR or QFR was compared to FFR. A bivariate model was applied to pool diagnostic parameters. Cochran’s Q test and the I2 index were used to assess heterogeneity and identify the potential source of heterogeneity by metaregression and sensitivity analysis. Results. Overall, 2220 and 3000 coronary lesions from 20 studies were evaluated by cFFR and QFR, respectively. The pooled sensitivity and specificity were 0.87 (95% CI: 0.81, 0.91) and 0.92 (95% CI: 0.88, 0.94) for cFFR and 0.87 (95% CI: 0.82, 0.91) and 0.91 (95% CI: 0.87, 0.93) for QFR, respectively. No statistical significance of sensitivity and specificity for cFFR and QFR were observed in the bivariate analysis ( P=0.8406 and 0.4397, resp.). The area under summary receiver-operating curve of cFFR and QFR was 0.95 (95% CI: 0.93, 0.97) for cFFR and 0.95 (95% CI: 0.93, 0.97). Conclusion. Both cFFR and QFR have good diagnostic performance in detecting functional severity of coronary arteries and showed similar diagnostic parameters.
No takes yet. Share an insight, caveat, or question.
Zhang et al. (2020) conducted a meta-analysis in Coronary stenosis. Contrast-fractional flow reserve (cFFR) and quantitative flow ratio (QFR) vs. Fractional flow reserve (FFR) was evaluated on Pooled sensitivity and specificity (Sensitivity 0.87, 95% CI 0.81-0.91, p=0.8406). Both cFFR and QFR demonstrated good diagnostic performance for evaluating coronary stenosis severity, with pooled sensitivities of 0.87 and specificities of 0.92 and 0.91, respectively.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: