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Characteristics of Function-Anatomy Mismatch in Patients with Coronary Artery Disease

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Author(s)
Hyun-Ok ChoChang-Wook NamYun-Kyeong ChoHyuck-Jun YoonHyoung-Seob ParkHyungseop KimIn-Sung ChungJoon-Hyung DohBon-Kwon KooDae-Woo HyunSeung-Ho HurYoon-Nyun KimKwon-Bae Kim
Keimyung Author(s)
Nam, Chang WookCho, Yun KyeongYoon, Hyuck JunPark, Hyoung SeobKim, Hyung SeopHur, Seung HoKim, Yoon NyunKim, Kwon BaeChung, In Sung
Department
Dept. of Internal Medicine (내과학)
Dept. of Preventive Medicine (예방의학)
Journal Title
Korean Circulation Journal
Issued Date
2014
Volume
44
Issue
6
Keyword
Fractional flow reservemyocardialCoronary angiographyCoronary artery disease
Abstract
Background and Objectives: Coronary lesions with mismatched functional and anatomical significance are not uncommon. We assessed the accuracy and predictors of mismatch between fractional flow reserve (FFR) and quantitative coronary angiography (QCA) analyses in patients with coronary lesions. Subjects and Methods: A total of 643 lesions with pre-interventional FFR and QCA measurements were consecutively enrolled and divided into four groups using FFR ≤0.80 and percent diameter stenosis (%DS) ≥50% as cutoffs for functional and anatomical significance, respectively. Accordingly, FFR >0.80 and DS ≥50%, and FFR ≤0.80 and DS <50% defined false-positive (FP) and false-negative (FN) lesions, respectively. Results: Overall, 40.4% (260/643) of the lesions were mismatched, and 51.7% (218/414) and 18.3% (42/229) were FP and FN lesions, respectively. In a multivariate analysis, independent predictors of FP were non-left anterior descending artery location {odds ratio (OR), 0.36; 95% confidence interval (CI), 0.28-0.56; p<0.001}, shorter lesion length (OR, 0.96; 95% CI, 0.95-0.98; p<0.001), multi-vessel disease (OR, 0.47; 95% CI, 0.30-0.75; p=0.001), and larger minimal lumen diameter by QCA (OR, 2.88; 95% CI,1.65-5.00; p<0.001). Independent predictors of FN were multi-vessel disease (OR, 1.82; 95% CI, 1.24-5.27; p=0.048), aging (OR, 0.96; 95% CI, 0.93-0.99; p=0.034), smoking (OR, 0.36; 95% CI, 0.14-0.93; p=0.034), and smaller reference vessel diameter by QCA (OR, 0.30; 95% CI, 0.10-0.87; p=0.026). Conclusion: A mismatch between FFR and angiographic lesion severity is not rare in patients with coronary artery disease; therefore, an angiography-guided evaluation could under- or over-estimate lesion severity in specific lesion subsets.
Keimyung Author(s)(Kor)
남창욱
조윤경
윤혁준
박형섭
김형섭
허승호
김윤년
김권배
정인성
Publisher
School of Medicine
Citation
Hyun-Ok Cho et al. (2014). Characteristics of Function-Anatomy Mismatch in Patients with Coronary Artery Disease. Korean Circulation Journal, 44(6), 394–399. doi: 10.4070/kcj.2014.44.6.394
Type
Article
ISSN
1738-5520
DOI
10.4070/kcj.2014.44.6.394
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36042
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
1. School of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학)
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