Document Detail

Head-to-head comparison of basal stenosis resistance index, instantaneous wave-free ratio, and fractional flow reserve: diagnostic accuracy for stenosis-specific myocardial ischaemia.
MedLine Citation:
PMID:  25169594     Owner:  NLM     Status:  Publisher    
Aims: We sought to compare the diagnostic accuracy of basal stenosis resistance index (BSR), instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR) for stenosis-specific myocardial ischaemia identified by means of a combined reference standard of myocardial perfusion scintigraphy and the hyperaemic stenosis resistance index. Methods and results: BSR and FFR were determined for 299 coronary stenoses, iFR was determined for 85 coronary stenoses (iFR cohort). The discriminative value for stenosis-specific myocardial ischaemia was compared by means of the area under the receiver operating characteristic (ROC) curves (AUC). Classification agreement with the reference standard was determined according to ROC curve-derived ischaemic cut-off values, as well as according to clinical cut-off values, equivalent to the 0.80 FFR cut-off. Across all stenoses, the discriminative value of BSR and FFR was equivalent (AUC: 0.90 and 0.91, respectively, p=0.46). In the iFR cohort, the discriminative value was equivalent for BSR, iFR, and FFR (AUC: 0.88, 0.84, and 0.88, respectively; p≥0.20 for all). At both ischaemic as well as clinical cut-off values, classification agreement with the reference standard was equivalent for BSR and FFR across all stenoses, as well as for BSR, iFR, and FFR in the iFR cohort. Conclusions: BSR, iFR, and FFR have equivalent diagnostic accuracy for the detection of ischaemia-generating coronary stenoses.
Tim P van de Hoef; Martijn Meuwissen; Javier Escaned; Sayan Sen; Ricardo Petraco; Martijn A van Lavieren; Mauro Echavarria-Pinto; Froukje Nolte; Sukhjinder Nijjer; Steven A J Chamuleau; Michiel Voskuil; Berthe L F van Eck-Smit; Hein J Verberne; José P S Henriques; Karel T Koch; Robbert J de Winter; Jos A E Spaan; Maria Siebes; Jan G P Tijssen; Justin E Davies; Jan J Piek
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-8-30
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  -     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-8-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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