Diagnostic Performance of Angiography-based Fractional Flow Reserve in Various Subgroups: Report from the FAST-FFR Study. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology Kobayashi, Y., Collet, C., Achenbach, S., Engstrøm, T., Assali, A., Shlofmitz, R. A., Fournier, S., Kirtane, A. J., Ali, Z. A., Kornowski, R., Leon, M. B., De Bruyne, B., Fearon, W. F., Jeremias, A., Greenberg, G., Jubeh, R., Kolansky, D. M., McAndrew, T., Dressler, O., Maehara, A., Matsumura, M. 2020


A large, prospective, multicenter trial recently showed that fractional flow reserve (FFR) derived from coronary angiography (FFRangio) has an accuracy of 92% compared with conventional guide-wire based FFR (FFRwire); however, little is known whether specific patient/lesion characteristics affect the diagnostic performance.FFRangio was measured in a blinded fashion in 301 patients (319 vessels) who were undergoing FFRwire assessment. Using an FFRwire =0.80 as a reference, the diagnostic performance of FFRangio was compared in pre-specified subgroups. The mean FFRwire and FFRangio were 0.81 ± 0.13 and 0.80 ± 0.12. Overall, FFRangio had a sensitivity of 93.5% and specificity of 91.2% for predicting FFRwire. Patient characteristics including age, sex, clinical presentation, body mass index, and diabetes did not affect sensitivity or specificity (p>0.05 for all). Similarly, lesion characteristics including calcification, tortuosity did not affect sensitivity or specificity (p>0.05 for all), nor did lesion location (proximal, middle, versus distal). Sensitivity was equally high across all target vessels, while specificity was highest in the LAD and lower (~85%) in the RCA and LCx (p<0.05).FFRangio derived from coronary angiography has a high diagnostic performance regardless of patient and most lesion characteristics. The interaction of vessel on the specificity will need to be confirmed in larger cohorts.

View details for DOI 10.4244/EIJ-D-19-00933

View details for PubMedID 32364503