Diagnostic performance of fractional flow reserve derived from coronary angiography, intravascular ultrasound, and optical coherence tomography; a meta-analysis

Tatsunori Takahashi, Doosup Shin, Toshiki Kuno, Joo Myung Lee, Azeem Latib, William F. Fearon, Akiko Maehara, Yuhei Kobayashi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Little is known about the overall diagnostic performance of computational fractional flow reserve (FFR) derived from angiography (Angio-FFR), intravascular ultrasound (IVUS-FFR), and optical coherence tomography (OCT-FFR) to detect hemodynamically significant coronary artery disease. The present study aimed to evaluate the diagnostic performance of those novel physiologic indices using conventional FFR as the gold standard. Methods: PubMed and Embase were searched in September 2021 for a systematic review and meta-analysis of studies assessing the diagnostic performance of invasive imaging-derived FFR. The primary outcomes were the summary sensitivity, specificity, correlation coefficients of each index. Results: A total of 6572 records were initially identified and 49 studies were included in the final analysis (7010 lesions from 36 studies for Angio-FFR, 305 lesions from 5 studies for IVUS-FFR, and 667 lesions from 8 studies for OCT-FFR). Invasive imaging-derived FFR had a high diagnostic performance to detect functionally significant coronary lesions using conventional FFR as the gold standard [Angio-FFR, sensitivity 0.87 (95% CI 0.84–0.89), specificity 0.93 (95% CI 0.910.95); IVUS-FFR, sensitivity 0.90 (95% CI 0.84–0.94), specificity 0.95 (95% CI 0.90–0.98); OCT-FFR, sensitivity 0.85 (95% CI 0.78–0.91), specificity 0.93 (95% CI 0.89–0.95)]. The summary correlation coefficients of Angio-, IVUS-, and OCT-FFRs with wire-based FFR were 0.83 (95% CI 0.80–0.85), 0.85 (95% CI 0.79–0.91), and 0.80 (95% CI 0.74–0.86), respectively. Conclusions: This meta-analysis demonstrated that computational FFR derived from invasive coronary imaging has clinically acceptable diagnostic performances irrespective of modalities, supporting their applicability to clinical practice.

Original languageEnglish (US)
JournalJournal of Cardiology
DOIs
StateAccepted/In press - 2022

Keywords

  • Coronary angiography
  • Coronary physiology
  • Fractional flow reserve
  • Intravascular ultrasound
  • Optical coherence tomography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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