Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients
Abstract The quantitative flow ratio (QFR) is a novel angiography-based computational method assessing functional ischemia caused by coronary stenosis. This study aimed to evaluate the diagnostic performance of quantitative flow ratio (QFR) in patients with angina and acute myocardial infarction (AM...
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Nature Portfolio
2021
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oai:doaj.org-article:3bd91babd2eb425d9bf3a6ca17e3e7902021-12-02T14:06:55ZInfluence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients10.1038/s41598-021-82235-y2045-2322https://doaj.org/article/3bd91babd2eb425d9bf3a6ca17e3e7902021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82235-yhttps://doaj.org/toc/2045-2322Abstract The quantitative flow ratio (QFR) is a novel angiography-based computational method assessing functional ischemia caused by coronary stenosis. This study aimed to evaluate the diagnostic performance of quantitative flow ratio (QFR) in patients with angina and acute myocardial infarction (AMI) and to identify the conditions with low diagnostic performance. We assessed the QFR for 1077 vessels under fractional flow ratio (FFR) evaluation in 915 patients with angina and AMI. The diagnostic accuracies of the QFR for identifying an FFR ≤ 0.8 were 95.98% (95% confidence interval [CI] 94.52 to 97.14%) for the angina group and 92.42% (95% CI 86.51 to 96.31%) for the AMI group. The diagnostic accuracy of the QFR in the borderline FFR zones (> 0.75, ≤ 0.85) (91.23% [95% CI 88.25 to 93.66%]) was significantly lower than that in others (difference: 4.32; p = 0.001). The condition accompanying both AMI and the borderline FFR zone showed the lowest QFR diagnostic accuracy in our data (83.93% [95% CI 71.67 to 92.38]). The diagnostic accuracy was reduced for tandem lesions (p = 0.04, not correcting for multiple testing). Our study found that the QFR method yielded a high overall diagnostic performance in real-world patients. However, low diagnostic accuracy has been observed in borderline FFR zones with AMI, and the hybrid FFR approach needs to be considered.Kwan Yong LeeByung-Hee HwangMoo Jun KimEun-Ho ChooIk Jun ChoiChan Jun KimSang-Wook LeeJoo Myung LeeMi-Jeong KimDoo Soo JeonWook Sung ChungHo-Joong YounKi Jun KimMyeong-Ho YoonKiyuk ChangNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021) |
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Medicine R Science Q |
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Medicine R Science Q Kwan Yong Lee Byung-Hee Hwang Moo Jun Kim Eun-Ho Choo Ik Jun Choi Chan Jun Kim Sang-Wook Lee Joo Myung Lee Mi-Jeong Kim Doo Soo Jeon Wook Sung Chung Ho-Joong Youn Ki Jun Kim Myeong-Ho Yoon Kiyuk Chang Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| description |
Abstract The quantitative flow ratio (QFR) is a novel angiography-based computational method assessing functional ischemia caused by coronary stenosis. This study aimed to evaluate the diagnostic performance of quantitative flow ratio (QFR) in patients with angina and acute myocardial infarction (AMI) and to identify the conditions with low diagnostic performance. We assessed the QFR for 1077 vessels under fractional flow ratio (FFR) evaluation in 915 patients with angina and AMI. The diagnostic accuracies of the QFR for identifying an FFR ≤ 0.8 were 95.98% (95% confidence interval [CI] 94.52 to 97.14%) for the angina group and 92.42% (95% CI 86.51 to 96.31%) for the AMI group. The diagnostic accuracy of the QFR in the borderline FFR zones (> 0.75, ≤ 0.85) (91.23% [95% CI 88.25 to 93.66%]) was significantly lower than that in others (difference: 4.32; p = 0.001). The condition accompanying both AMI and the borderline FFR zone showed the lowest QFR diagnostic accuracy in our data (83.93% [95% CI 71.67 to 92.38]). The diagnostic accuracy was reduced for tandem lesions (p = 0.04, not correcting for multiple testing). Our study found that the QFR method yielded a high overall diagnostic performance in real-world patients. However, low diagnostic accuracy has been observed in borderline FFR zones with AMI, and the hybrid FFR approach needs to be considered. |
| format |
article |
| author |
Kwan Yong Lee Byung-Hee Hwang Moo Jun Kim Eun-Ho Choo Ik Jun Choi Chan Jun Kim Sang-Wook Lee Joo Myung Lee Mi-Jeong Kim Doo Soo Jeon Wook Sung Chung Ho-Joong Youn Ki Jun Kim Myeong-Ho Yoon Kiyuk Chang |
| author_facet |
Kwan Yong Lee Byung-Hee Hwang Moo Jun Kim Eun-Ho Choo Ik Jun Choi Chan Jun Kim Sang-Wook Lee Joo Myung Lee Mi-Jeong Kim Doo Soo Jeon Wook Sung Chung Ho-Joong Youn Ki Jun Kim Myeong-Ho Yoon Kiyuk Chang |
| author_sort |
Kwan Yong Lee |
| title |
Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| title_short |
Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| title_full |
Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| title_fullStr |
Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| title_full_unstemmed |
Influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| title_sort |
influence of lesion and disease subsets on the diagnostic performance of the quantitative flow ratio in real-world patients |
| publisher |
Nature Portfolio |
| publishDate |
2021 |
| url |
https://doaj.org/article/3bd91babd2eb425d9bf3a6ca17e3e790 |
| work_keys_str_mv |
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