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Diagnostic performance of computed tomography derived fractional flow reserve on functional ischemia of coronary stenosis in each culprit vessel

Session Poster session 1

Speaker Akihiro Suzuki

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : H Takashima (Aichi,JP), A Suzuki (Aichi,JP), H Ando (Aichi,JP), K Waseda (Aichi,JP), A Kurita (Aichi,JP), S Sakurai (Aichi,JP), Y Saka (Aichi,JP), H Sawada (Aichi,JP), T Amano (Aichi,JP)

Authors:
H. Takashima1 , A. Suzuki1 , H. Ando1 , K. Waseda1 , A. Kurita1 , S. Sakurai1 , Y. Saka1 , H. Sawada1 , T. Amano1 , 1Aichi Medical University - Aichi - Japan ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 190-191

Background: Fractional flow reserve (FFR) is the gold standard for identifying functional severity of coronary artery disease (CAD). Although computation of FFR from coronary computed tomography angiography (FFRct) recently provided high diagnostic accuracy for identifying functional lesion severity, it was unclear whether those were similar in each vessel.

Purpose: The purpose of this study was to evaluate the diagnostic performance of FFRct between left anterior descending artery (LAD) and non-LAD.

Methods: We prospectively enrolled stable CAD patients with 47 lesions which were performed both FFRct and invasive FFR measurements. Functional ischemia was defined as FFR ≤0.80.

Results: In this subjects, 26 lesions were distributed in LAD. FFRct showed a good correlation with invasive FFR (r=0.71, p<0.01). From the ROC curve analysis, the diagnostic accuracy of FFRct was 81% (AUC 0.87, sensitivity 89%, specificity 76%) in overall subjects. The diagnostic accuracy was higher in LAD than in non-LAD (88% vs. 52%). The Bland-Altman plot between FFRct and invasive FFR demonstrated better agreement with a mean difference of 0.019 and a standard deviation of 0.063 in LAD compared to a mean difference of 0.108 and 0.073 in non-LAD.

Conclusion: FFRct provides high diagnostic accuracy and discrimination for the diagnosis of functionally significant stenosis with invasive FFR. The diagnostic accuracy of FFRct might be different between LAD and non-LAD.

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