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
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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.
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