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Diagnostic accuracy of instantaneous wave free-ratio in clinical practice.

Abstract：

AIMS:To evaluate the correlation between iFR and FFR in real-world clinical practice. METHODS AND RESULTS:Retrospective, single-centre study of 229 consecutive pressure-wire studies (np  = 158). Real-time iFR and FFR measurements were performed for angiographically borderline stenoses. Functionally significant stenoses were defined as iFR <0.86 or FFR ≤0.80. An iFR between 0.86 and 0.93 was considered within the grey zone (Hybrid approach). Median iFR and FFR (IQR) were 0.92 (0.87-0.95) and 0.83 (0.76-0.89), respectively. Pearson's correlation coefficient was 0.75 (P < 0.001). Bland-Altman plot showed a mean difference between iFR and FFR that remained consistent throughout the range of values. The optimal iFR cutoff was 0.91-sensitivity 80%, specificity 82% with ROC area under curve of 89%. Using the Hybrid iFR-FFR strategy, we demonstrated high accuracy of iFR results-sensitivity 95%, specificity 96%, PPV 95%, and NPV 96%. In addition, this method would have avoided adenosine in 56% of patients. Mean follow-up period was 17.2 (±3.4) months. All-cause mortality was 3.2% (np  = 5) and repeat intervention was required in six lesions (2.6%). CONCLUSIONS:This study demonstrates that iFR is a valuable adjunct to FFR using the Hybrid iFR-FFR strategy in a real-world population. The use of adenosine may be avoided in about half the cases.

journal_name

J Interv Cardiol

journal_title

Journal of interventional cardiology

authors

Ding WY,Nair S,Appleby C

doi

10.1111/joic.12422

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

564-569

issue

6

eissn

0896-4327

issn

1540-8183

journal_volume

30

pub_type

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