Details

Autor(en) / Beteiligte

• Collet, Carlos
• Onuma, Yoshinobu
• Sonck, Jeroen
• Asano, Taku
• Vandeloo, Bert
• Kornowski, Ran
• Tu, Shengxian
• Westra, Jelmer
• Holm, Niels R
• Xu, Bo
• de Winter, Robbert J
• Tijssen, Jan G
• Miyazaki, Yosuke
• Katagiri, Yuki
• Tenekecioglu, Erhan
• Modolo, Rodrigo
• Chichareon, Ply
• Cosyns, Bernard
• Schoors, Daniel
• Roosens, Bram
• Lochy, Stijn
• Argacha, Jean-Francois
• van Rosendael, Alexandre
• Bax, Jeroen
• Reiber, Johan H C
• Escaned, Javier
• De Bruyne, Bernard
• Wijns, William
• Serruys, Patrick W

Titel

Diagnostic performance of angiography-derived fractional flow reserve: a systematic review and Bayesian meta-analysis

Ist Teil von

• European heart journal, 2018-09, Vol.39 (35), p.3314-3321

Ort / Verlag

England: Oxford University Press

Erscheinungsjahr

2018

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Aims Pressure-wire assessment of coronary stenosis is considered the invasive reference standard for detection of ischaemia-generating lesions. Recently, methods to estimate the fractional flow reserve (FFR) from conventional angiography without the use of a pressure wire have been developed, and were shown to have an excellent diagnostic accuracy. The present systematic review and meta-analysis aimed at determining the diagnostic performance of angiography-derived FFR for the diagnosis of haemodynamically significant coronary artery disease. Methods and results A systematic review and meta-analysis of studies assessing the diagnostic performance of angiography-derived FFR systems were performed. The primary outcome of interest was pooled sensitivity and specificity. Thirteen studies comprising 1842 vessels were included in the final analysis. A Bayesian bivariate meta-analysis yielded a pooled sensitivity of 89% (95% credible interval 83–94%), specificity of 90% (95% credible interval 88–92%), positive likelihood ratio (+LR) of 9.3 (95% credible interval 7.3–11.7) and negative likelihood ratio (−LR) of 0.13 (95% credible interval 0.07–0.2). The summary area under the receiver-operating curve was 0.84 (95% credible interval 0.66–0.94). Meta-regression analysis did not find differences between the methods for pressure-drop calculation (computational fluid dynamics vs. mathematical formula), type of analysis (on-line vs. off-line) or software packages. Conclusion The accuracy of angiography-derived FFR was good to detect haemodynamically significant lesions with pressure-wire measured FFR as a reference. Computational approaches and software packages did not influence the diagnostic accuracy of angiography-derived FFR. A diagnostic strategy trial with angiography-derived FFR evaluating clinical endpoints is warranted.