Three-dimensional quantitative coronary angiography and quantification of jeopardised myocardium to predict functional significance of intermediate coronary artery stenosis

Francesco Burzotta, Carlo Trani, Filippo Crea, Antonio Maria Leone, Alberto De Caterina, Giovanni Luigi De Maria, Giancarla Scalone, Eloisa Basile, Pio Cialdella, Cristina Aurigemma, Italo Porto, Giampaolo Niccoli, Antonio Giuseppe Rebuzzi, Alberto Ranieri De Caterina, Adrian Paul Banning

Risultato della ricerca: Contributo in rivistaArticolo in rivista

1 Citazioni (Scopus)

Abstract

Aims: Despite the fact that fractional flow reserve (FFR) is better than angiography in guiding PCI, in the real world the choice to perform PCI is generally based on angiography. Three-dimensional quantitative coronary angiography (3D-QCA) may increase the accuracy of angiography, especially in intermediate coronary artery stenosis (ICAS). The aim of the study was to assess the best cut-off values of area stenosis % (AS%) and the extent of jeopardised myocardium for predicting FFR and for excluding the need to perform FFR. Methods and results: FFR, AS% and Myocardial Jeopardy Index (MJI) were assessed in 211 ICAS. MJI (β=-0.36; p=0.001), AS% (β=-0.35; p=0.001) and presence of a chronic total occlusion (CTO) (β=-0.15; p=0.01) were independent predictors of FFR. In patients without CTO (174 lesions), the best cut-offs for the detection of FFR ≤0.80 for AS% and MJI were 61% (AUC=0.76; p<0.001) and 30% (AUC=0.71; p<0.001), respectively. More importantly, the cut-offs of AS% safely to exclude (100% sensitivity) an FFR ≤0.80 were 40% (AUC=0.85, p<0.001) for an MJI ≥30% and 50% (AUC=0.70, p<0.04) for an MJI <30%, respectively. Conclusions: AS%, MJI and the presence of a CTO predicted FFR values. 3D-QCA in addition to MJI allows the safe exclusion of FFR ≤0.80, limiting FFR assessment to doubtful cases with considerable reduction of costs.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaEuroIntervention
Stato di pubblicazionePubblicato - 2014

Keywords

  • fractional flow reserve
  • percutaneus coronary interventions

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