Fractional flow reserve (FFR) measured using coronary angiogram achieved greater diagnostic accuracy compared to invasive pressure-wire, according to a 10-center study published in Circulation.
Despite research tying coronary pressure wire-measured-derived FFR to improved clinical outcomes, the method remains underutilized due to its lengthy process, technical challenges, associated risks and additional expenses.
“For all of these reasons, a technique for deriving FFR without the need of a pressure wire or hyperemic agent would be advantageous and could increase the adoption of physiology-guided revascularization,” wrote corresponding author William F. Fearon, MD, with Stanford University School of Medicine in Calif., and colleagues.
In the study—FAST-FFR: Diagnostic Accuracy of FFRangio—Fearon et al. enrolled 301 patients with suspected coronary artery disease who were evaluated at 10 centers in the U.S., Europe and Israel. Operators blinded to FFR used propriety software to convert angiograms into three-dimensional reconstructions of the coronary tree to calculate FFRangio.
Angiography-derived FFR obtained a per-vessel sensitivity and specificity of 94 percent and 91 percent, respectively, the authors noted. Overall, FFRangio achieved a diagnostic accuracy of 92 percent, which held steady at 87 percent when considering only FFR values between 0.75 and 0.85.
“The clinical implications of the current report are that FFRangio may provide an easier and potentially faster method for performing physiology guided assessment of the overall coronary angiogram with similar accuracy to the reference standard, coronary pressure wire-based FFR,” the authors concluded. “This may translate into a greater percentage of patients undergoing physiologic guidance for revascularization decisions and ultimately improve long-term outcomes.”
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.