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New Perspective on the Fractional Flow Reserve: High Predictive Value of Baseline Pd/Pa during Intracoronary Pressure Wire Study |
양산부산대학교병원 순환기내과 |
김정수, 전국진, 김준홍, 김준, 박용현, 송성국, 한동철 |
Objective
Fractional flow reserve tests using intracoronary pressure wire are widely used in practice for the assessment of the significance of coronary artery disease. We investigate the meaning of a baseline Pd/Pa during FFR study.
Methods and Materials
We analyzed the 399 consecutive intracoronary pressure wire study data performed in our hospital using a 'Radi' system for a couple of years. Predictive values of baseline Pd/Pa were calculated by FFR measured after maximal hyperemia. We defined FFR value as positive if FFRhyperemia ≤ 0.80 (as in the FAME study) and/or ≤ 0.75 (as in the DEFER study).
Results
A total of 399 studies, 157 (39.3%) were positive when the FAME study criteria was applied and 114 (28.6%) were positive when the DEFER study criteria was applied. A baseline Pd/Pa ≥ 0.96 has a 95.9% ( of negative predictive value (NPV) and a 60.2% of positive predictive value (PPV) when a FFRhyperemia ≤ 0.80 is defined as a positive (as in the FAME study). And a baseline Pd/Pa ≥ 0.96 has a 98.0% of NPV and a 44.2% of PPV when a FFRhyperemia ≤ 0.75 is defined as a positive (as in the DEFER study).
Conclusion
We found that baseline Pd/Pa ≥ 0.96 has very high NPV based on either FAME or DEFER criteria. These results would give a important massage that we do not need to induce hyperemia during intracoronary pressure wire study if baseline Pd/Pa is ≥ 0.96 in most cases.
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