AIMS: To evaluate the diagnostic performance of OCT-based optical flow ratio (OFR) in unselected patients and compare it with angiography-based quantitative flow ratio (QFR), using wire-based FFR as reference standard. METHODS AND RESULTS: All patients with OCT and FFR assessment prior to revascularization were analyzed. OFR and QFR were computed in blinded fashion and compared with FFR, all applying same cut-off value of ≤0.80 to define ischemia. Paired comparison between OFR and QFR was performed in 212 vessels from 181 patients. Average FFR was 0.82±0.10 and 40.1% vessels had FFR≤0.80. OFR showed significant better correlation and agreement with FFR than QFR (r=0.87 versus 0.77, p<0.001; SD of the difference=0.05 versus 0.07, p<0.001). The AUC was 0.97 for OFR, higher than QFR (difference=0.05, p=0.017), and much higher than minimal lumen area (difference=0.15, p<0.001) and diameter stenosis (difference=0.17, p<0.001). Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for OFR to identify FFR≤0.80 was 92%, 86%, 95%, 92%, 91%, 18.2 and 0.2, respectively. Diagnostic accuracy of OFR was not significantly different in MI-related vessels (95% versus 90%, p=0.456), nor in vessels with and without previously implanted stents (90% versus 93%, p=0.669). CONCLUSIONS: OFR had an excellent agreement with FFR in consecutive patients with coronary artery disease. OFR was superior than QFR, and much better than conventional morphological parameters in determining physiological significance of coronary stenosis. The diagnostic performance of OFR was not influenced by presence of prior myocardial infarction or implanted stents.
AIMS: To evaluate the diagnostic performance of OCT-based optical flow ratio (OFR) in unselected patients and compare it with angiography-based quantitative flow ratio (QFR), using wire-based FFR as reference standard. METHODS AND RESULTS: All patients with OCT and FFR assessment prior to revascularization were analyzed. OFR and QFR were computed in blinded fashion and compared with FFR, all applying same cut-off value of ≤0.80 to define ischemia. Paired comparison between OFR and QFR was performed in 212 vessels from 181 patients. Average FFR was 0.82±0.10 and 40.1% vessels had FFR≤0.80. OFR showed significant better correlation and agreement with FFR than QFR (r=0.87 versus 0.77, p<0.001; SD of the difference=0.05 versus 0.07, p<0.001). The AUC was 0.97 for OFR, higher than QFR (difference=0.05, p=0.017), and much higher than minimal lumen area (difference=0.15, p<0.001) and diameter stenosis (difference=0.17, p<0.001). Diagnostic accuracy, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio for OFR to identify FFR≤0.80 was 92%, 86%, 95%, 92%, 91%, 18.2 and 0.2, respectively. Diagnostic accuracy of OFR was not significantly different in MI-related vessels (95% versus 90%, p=0.456), nor in vessels with and without previously implanted stents (90% versus 93%, p=0.669). CONCLUSIONS: OFR had an excellent agreement with FFR in consecutive patients with coronary artery disease. OFR was superior than QFR, and much better than conventional morphological parameters in determining physiological significance of coronary stenosis. The diagnostic performance of OFR was not influenced by presence of prior myocardial infarction or implanted stents.
Authors: Makoto Araki; Seung-Jung Park; Harold L Dauerman; Shiro Uemura; Jung-Sun Kim; Carlo Di Mario; Thomas W Johnson; Giulio Guagliumi; Adnan Kastrati; Michael Joner; Niels Ramsing Holm; Fernando Alfonso; William Wijns; Tom Adriaenssens; Holger Nef; Gilles Rioufol; Nicolas Amabile; Geraud Souteyrand; Nicolas Meneveau; Edouard Gerbaud; Maksymilian P Opolski; Nieves Gonzalo; Guillermo J Tearney; Brett Bouma; Aaron D Aguirre; Gary S Mintz; Gregg W Stone; Christos V Bourantas; Lorenz Räber; Sebastiano Gili; Kyoichi Mizuno; Shigeki Kimura; Toshiro Shinke; Myeong-Ki Hong; Yangsoo Jang; Jin Man Cho; Bryan P Yan; Italo Porto; Giampaolo Niccoli; Rocco A Montone; Vikas Thondapu; Michail I Papafaklis; Lampros K Michalis; Harmony Reynolds; Jacqueline Saw; Peter Libby; Giora Weisz; Mario Iannaccone; Tommaso Gori; Konstantinos Toutouzas; Taishi Yonetsu; Yoshiyasu Minami; Masamichi Takano; O Christopher Raffel; Osamu Kurihara; Tsunenari Soeda; Tomoyo Sugiyama; Hyung Oh Kim; Tetsumin Lee; Takumi Higuma; Akihiro Nakajima; Erika Yamamoto; Krzysztof L Bryniarski; Luca Di Vito; Rocco Vergallo; Francesco Fracassi; Michele Russo; Lena M Seegers; Iris McNulty; Sangjoon Park; Marc Feldman; Javier Escaned; Francesco Prati; Eloisa Arbustini; Fausto J Pinto; Ron Waksman; Hector M Garcia-Garcia; Akiko Maehara; Ziad Ali; Aloke V Finn; Renu Virmani; Annapoorna S Kini; Joost Daemen; Teruyoshi Kume; Kiyoshi Hibi; Atsushi Tanaka; Takashi Akasaka; Takashi Kubo; Satoshi Yasuda; Kevin Croce; Juan F Granada; Amir Lerman; Abhiram Prasad; Evelyn Regar; Yoshihiko Saito; Mullasari Ajit Sankardas; Vijayakumar Subban; Neil J Weissman; Yundai Chen; Bo Yu; Stephen J Nicholls; Peter Barlis; Nick E J West; Armin Arbab-Zadeh; Jong Chul Ye; Jouke Dijkstra; Hang Lee; Jagat Narula; Filippo Crea; Sunao Nakamura; Tsunekazu Kakuta; James Fujimoto; Valentin Fuster; Ik-Kyung Jang Journal: Nat Rev Cardiol Date: 2022-04-21 Impact factor: 49.421
Authors: Federico Marin; Roberto Scarsini; Dimitrios Terentes-Printzios; Rafail A Kotronias; Flavio Ribichini; Adrian P Banning; Giovanni Luigi De Maria Journal: Curr Cardiol Rev Date: 2022