The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Comparison of Diagnostic Performance of Intracoronary Optical Coherence Tomography-based and Angiography-based Fractional Flow Reserve for Evaluation of Coronary Stenosis

DOI: 10.4244/EIJ-D-19-01034

1. Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China; The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway, Ireland
2. Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
3. Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China, China
4. Department of Interventional Cardiology, Campo de Gibraltar Health Trust, Algeciras, Spain
5. The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway, Ireland
Disclaimer:

As a public service to our readership, this article - peer reviewed by the Editors of EuroIntervention - has been published immediately upon acceptance as it was received. The content of this article is the sole responsibility of the authors, and not that of the journal or its publishers.

Please note that supplementary movies are not available online at this stage. Once a paper is published in its edited and formatted form, it will be accompanied online by any supplementary movies.

To read the full content of this article, please log in to download the PDF.

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.

Sign in to read and download the full article

Forgot your password?
No account yet? Sign up for free!
Create my pcr account

Join us for free and access thousands of articles from EuroIntervention, as well as presentations, videos, cases from PCRonline.com

Read next article

From Paris to Amsterdam: EuroPCR, ESC 2020 and spotlight on "The Cutting Edge of Cardiology"

Latest news