Accuracy of 3-dimensional and 2-dimensional quantitative coronary angiography for predicting physiological significance of coronary stenosis: a FAVOR II substudy

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  • Daixin Ding, Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai 200030, China.
  • ,
  • Junqing Yang, Department of Cardiology, Guangdong Provincial People's Hospital, Guangzhou 510055, China.
  • ,
  • Jelmer Westra
  • Yundai Chen, Department of Cardiology, PLA General Hospital, Beijing 100853, China.
  • ,
  • Yunxiao Chang, Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai 200030, China.
  • ,
  • Martin Sejr-Hansen
  • Su Zhang, Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai 200030, China.
  • ,
  • Evald H Christiansen
  • Niels R Holm
  • Bo Xu, Fu Wai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing 100037, China.
  • ,
  • Shengxian Tu, Shanghai Med-X Engineering Research Center, Shanghai Jiao Tong University, Shanghai 200030, China.

Background: Three-dimensional quantitative coronary angiography (3D-QCA) enables reconstruction of a coronary artery in 3D from two angiographic image projections. This study compared the diagnostic accuracy of 3D-QCA vs. 2-dimensional (2D) QCA in predicting physiologically significant coronary stenosis, using fractional flow reserve (FFR) as the reference standard.

Methods: All interrogated vessels in the FAVOR II China study and the FAVOR II Europe-Japan study were assessed by 2D-QCA and 3D-QCA according to standard operating procedures in core laboratories. QCA analysts were blinded to the corresponding FFR values.

Results: A total of 645 vessels from 576 patients with 3D-QCA, 2D-QCA, and FFR were analyzed. Using the conventional cut-off value of 50% for percent diameter stenosis (DS%), 3D-QCA was more accurate in predicting FFR ≤0.80 than 2D-QCA [accuracy 74.0% (95% CI: 69.9-77.7%) vs. 64.9% (95% CI: 61.3-68.7%), difference: 9.1%, P<0.001]. Sensitivity was higher by 3D-QCA compared with 2D-QCA [69.1% (95% CI: 63.0-75.1%) vs. 47.1% (95% CI: 40.5-53.6%), difference: 22.0%, P<0.001] and specificity was similar [76.5% (95% CI: 72.5-80.6%) vs. 74.4% (95% CI: 70.2-78.6%), difference: 2.1%, P=0.40]. Area under the receiver operating characteristic curve was significantly higher for 3D-QCA than for 2D-QCA [0.81 (95% CI: 0.77-0.84) vs. 0.66 (95% CI: 0.62-0.71), P<0.001].

Conclusions: 3D-QCA demonstrated better diagnostic performance in predicting physiologically significant coronary stenosis compared with 2D-QCA, when FFR was used as the reference standard.

OriginalsprogEngelsk
TidsskriftCardiovascular diagnosis and therapy
Vol/bind9
Nummer5
Sider (fra-til)481-491
Antal sider11
ISSN2223-3652
DOI
StatusUdgivet - okt. 2019

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2019 Cardiovascular Diagnosis and Therapy. All rights reserved.

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