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Clinical relevance and prognostic implications of contrast quantitative flow ratio in patients with coronary artery disease

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Author(s)
Ki Hong ChoiSeung Hun LeeJoo Myung LeeDoyeon HwangJinlong ZhangJihoon KimSe Young ImHyun Kuk KimChang-Wook NamJoon-Hyung DohEun-Seok ShinHernán Mejía-RenteríaTaek Kyu ParkJeong Hoon YangYoung Bin SongJoo-Yong HahnSeung-Hyuk ChoiHyeon-Cheol GwonJavier EscanedBon-Kwon Koo
Keimyung Author(s)
Nam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
International journal of cardiology
Issued Date
2020
Volume
235
Keyword
Fractional flow reserveQuantitative flow ratioQuantitative coronary angiographyOutcomesPrognosis
Abstract
Background:
We sought to evaluate the diagnostic performance of contrast quantitative flow ratio (cQFR) in all-comer patients with coronary artery disease, and to compare the vessel-oriented composite outcomes (VOCO) according to cQFR values.

Method:
599 vessels with 452 patients who underwent clinically indicated fractional flow reserve (FFR) and cQFR measurement were evaluated. The cQFR, derived from 3-dimensional quantitative coronary angiography combined with TIMI frame-counts was compared with FFR as a reference standard. The risk of VOCO at 2 years, a composite of cardiac death, target-vessel myocardial infarction, and ischemia-driven target lesion revascularization, was compared according to cQFR and FFR value.

Results:
cQFR strongly correlated with FFR (r=0.860, p<0.001) and showed diagnostic accuracy of 91.2% to predict FFR≤0.80. cQFR showed significantly higher c-index to predict FFR≤0.80 (0.953, 95%CI 0.937-0.969) than %DS, percent area stenosis, resting distal coronary pressure/aortic pressure, and fixed QFR (p<0.001). Diagnostic accuracy of cQFR was not different according to various subgroups including non-culprit vessel of acute coronary syndrome and diabetes mellitus. Vessels with low cQFR (≤0.80) showed a significantly higher risk of VOCO at 2-year compared to those with high cQFR (>0.80) (HR 4.650, 95%CI 1.254-17.240, p=0.022). Discriminatory ability of cQFR for VOCO was similar with that of FFR (0.672 vs. 0.643, p=0.147).

Conclusion:
cQFR showed excellent correlation and diagnostic accuracy with FFR in diverse clinical presentations or patient characteristics. Low cQFR was significantly associated with a higher risk of VOCO at 2 years compared with high cQFR and cQFR showed similar discriminatory ability for VOCO with FFR.
Keimyung Author(s)(Kor)
남창욱
Publisher
School of Medicine (의과대학)
Citation
Ki Hong Choi et al. (2020). Clinical relevance and prognostic implications of contrast quantitative flow ratio in patients with coronary artery disease. International journal of cardiology, 235, 23–29. doi: 10.1016/j.ijcard.2020.09.002
Type
Article
ISSN
1874-1754
Source
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0167527320337360
DOI
10.1016/j.ijcard.2020.09.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43103
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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