TY - JOUR
T1 - Head-to-head comparison of basal stenosis resistance index, instantaneous wave-free ratio, and fractional flow reserve
T2 - diagnostic accuracy for stenosis-specific myocardial ischaemia
AU - van de Hoef, Tim P
AU - Meuwissen, Martijn
AU - Escaned, Javier
AU - Sen, Sayan
AU - Petraco, Ricardo
AU - van Lavieren, Martijn A
AU - Echavarria-Pinto, Mauro
AU - Nolte, Froukje
AU - Nijjer, Sukhjinder
AU - Chamuleau, Steven A J
AU - Voskuil, Michiel
AU - van Eck-Smit, Berthe L F
AU - Verberne, Hein J
AU - Henriques, José P S
AU - Koch, Karel T
AU - de Winter, Robbert J
AU - Spaan, Jos A E
AU - Siebes, Maria
AU - Tijssen, Jan G P
AU - Davies, Justin E
AU - Piek, Jan J
PY - 2015/12/22
Y1 - 2015/12/22
N2 - 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.
AB - 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.
U2 - 10.4244/EIJY14M08_17
DO - 10.4244/EIJY14M08_17
M3 - Article
C2 - 25169594
SN - 1774-024X
VL - 11
SP - 914
EP - 925
JO - EuroIntervention
JF - EuroIntervention
IS - 8
ER -