Diagnostic performance of quantitative flow ratio in prospectively enrolled patients : An individual patient-data meta-analysis
© 2019 Wiley Periodicals, Inc..
OBJECTIVES: We aimed to provide robust performance estimates for quantitative flow ratio (QFR) in assessment of intermediary coronary lesions.
BACKGROUND: Angiography-based functional lesion assessment by QFR may appear as a cost saving and safe approach to expand the use of physiology-guided percutaneous coronary interventions. QFR was proven feasible and showed good diagnostic performance in mid-sized off-line and on-line studies with fractional flow reserve (FFR) as reference standard.
METHODS: We performed a collaborative individual patient-data meta-analysis of all available prospective studies with paired assessment of QFR and FFR using the CE-marked QFR application. The main outcome was agreement of QFR and FFR using a two-step analysis strategy with a multilevel mixed model accounting for study and center level variation.
RESULTS: Of 16 studies identified, four studies had prospective enrollment and provided patient level data reaching a total of 819 patients and 969 vessels with paired FFR and QFR: FAVOR Pilot (n = 73); WIFI II (n = 170); FAVOR II China (n = 304) and FAVOR II Europe-Japan (n = 272). We found an overall agreement (mean difference 0.009 ± 0.068, I2 = 39.6) of QFR with FFR. The diagnostic performance was sensitivity 84% (95%CI: 77-90, I2 = 70.1), specificity 88% (95%CI: 84-91, I2 = 60.1); positive predictive value 80% (95%CI: 76-85, I2 = 33.4), and negative predictive value 95% (95%CI: 93-96, I2 = 75.9).
CONCLUSIONS: Diagnostic performance of QFR was good with FFR as reference in this meta-analysis of high quality studies. QFR could provide an easy, safe, and cost-effective solution for functional evaluation of coronary artery stenosis.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:94 |
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| Enthalten in: |
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions - 94(2019), 5 vom: 01. Nov., Seite 693-701 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Westra, Jelmer [VerfasserIn] |
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| Links: |
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| Themen: |
Coronary artery disease |
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| Anmerkungen: |
Date Completed 25.08.2020 Date Revised 25.08.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ccd.28283 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM295851600 |
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| 100 | 1 | |a Westra, Jelmer |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Diagnostic performance of quantitative flow ratio in prospectively enrolled patients |b An individual patient-data meta-analysis |
| 264 | 1 | |c 2019 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 25.08.2020 | ||
| 500 | |a Date Revised 25.08.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2019 Wiley Periodicals, Inc. | ||
| 520 | |a OBJECTIVES: We aimed to provide robust performance estimates for quantitative flow ratio (QFR) in assessment of intermediary coronary lesions | ||
| 520 | |a BACKGROUND: Angiography-based functional lesion assessment by QFR may appear as a cost saving and safe approach to expand the use of physiology-guided percutaneous coronary interventions. QFR was proven feasible and showed good diagnostic performance in mid-sized off-line and on-line studies with fractional flow reserve (FFR) as reference standard | ||
| 520 | |a METHODS: We performed a collaborative individual patient-data meta-analysis of all available prospective studies with paired assessment of QFR and FFR using the CE-marked QFR application. The main outcome was agreement of QFR and FFR using a two-step analysis strategy with a multilevel mixed model accounting for study and center level variation | ||
| 520 | |a RESULTS: Of 16 studies identified, four studies had prospective enrollment and provided patient level data reaching a total of 819 patients and 969 vessels with paired FFR and QFR: FAVOR Pilot (n = 73); WIFI II (n = 170); FAVOR II China (n = 304) and FAVOR II Europe-Japan (n = 272). We found an overall agreement (mean difference 0.009 ± 0.068, I2 = 39.6) of QFR with FFR. The diagnostic performance was sensitivity 84% (95%CI: 77-90, I2 = 70.1), specificity 88% (95%CI: 84-91, I2 = 60.1); positive predictive value 80% (95%CI: 76-85, I2 = 33.4), and negative predictive value 95% (95%CI: 93-96, I2 = 75.9) | ||
| 520 | |a CONCLUSIONS: Diagnostic performance of QFR was good with FFR as reference in this meta-analysis of high quality studies. QFR could provide an easy, safe, and cost-effective solution for functional evaluation of coronary artery stenosis | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a coronary artery disease | |
| 650 | 4 | |a fractional flow reserve | |
| 650 | 4 | |a quantitative coronary angiography | |
| 650 | 4 | |a quantitative flow ratio | |
| 700 | 1 | |a Tu, Shengxian |e verfasserin |4 aut | |
| 700 | 1 | |a Campo, Gianluca |e verfasserin |4 aut | |
| 700 | 1 | |a Qiao, Shubin |e verfasserin |4 aut | |
| 700 | 1 | |a Matsuo, Hitoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Qu, Xinkai |e verfasserin |4 aut | |
| 700 | 1 | |a Koltowski, Lukasz |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Yunxiao |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Tommy |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Junqing |e verfasserin |4 aut | |
| 700 | 1 | |a Andersen, Birgitte Krogsgaard |e verfasserin |4 aut | |
| 700 | 1 | |a Eftekhari, Ashkan |e verfasserin |4 aut | |
| 700 | 1 | |a Christiansen, Evald Høj |e verfasserin |4 aut | |
| 700 | 1 | |a Escaned, Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Wijns, William |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Bo |e verfasserin |4 aut | |
| 700 | 1 | |a Holm, Niels Ramsing |e verfasserin |4 aut | |
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