Quantitative flow ratio for immediate assessment of nonculprit lesions in patients with ST-segment elevation myocardial infarction-An iSTEMI substudy

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Quantitative flow ratio for immediate assessment of nonculprit lesions in patients with ST-segment elevation myocardial infarction-An iSTEMI substudy. / Sejr-Hansen, Martin; Westra, Jelmer; Thim, Troels; Christiansen, Evald Høj; Eftekhari, Ashkan; Kristensen, Steen Dalby; Jakobsen, Lars; Götberg, Matthias; Frøbert, Ole; van der Hoeven, Nina W; Holm, Niels Ramsing; Maeng, Michael.

I: Catheterization and Cardiovascular Interventions, Bind 94, Nr. 5, 01.11.2019, s. 686-692.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{6b9135ff91bd4fd4bd0fa4e61742a753,
title = "Quantitative flow ratio for immediate assessment of nonculprit lesions in patients with ST-segment elevation myocardial infarction-An iSTEMI substudy",
abstract = "OBJECTIVES: We evaluated the diagnostic performance of quantitative flow ratio (QFR) assessment of nonculprit lesions (NCLs) based on acute setting angiograms obtained in patients with ST-segment elevation myocardial infarction (STEMI) with QFR, fractional flow reserve (FFR), and instantaneous wave-free ratio (iFR) in the staged setting as reference.BACKGROUND: QFR is an angiography-based approach for the functional evaluation of coronary artery lesions.METHODS: This was a post-hoc analysis of the iSTEMI study. NCLs were assessed with iFR in the acute setting and with iFR and FFR at staged (median 13 days) follow-up. Acute and staged QFR values were computed in a core laboratory based on the coronary angiography recordings. Diagnostic cut-off values were ≤0.80 for QFR and FFR, and ≤0.89 for iFR.RESULTS: Staged iFR and FFR data were available for 146 NCLs in 112 patients in the iSTEMI study. Among these, QFR analysis was feasible in 103 (71%) lesions assessed in the acute setting with a mean QFR value of 0.82 (IQR: 0.73-0.91). Staged QFR, FFR, and iFR were 0.80 (IQR: 0.70-0.90), 0.81 (IQR: 0.71-0.88), and 0.91 (IQR: 0.87-0.96), respectively. Classification agreement of acute and staged QFR was 93% (95%Cl: 87-99). The classification agreement of acute QFR was 84% (95%CI: 76-90) using staged FFR as reference and 74% (95%CI: 65-83) using staged iFR as reference.CONCLUSIONS: Acute QFR showed a very good diagnostic performance with staged QFR as reference, a good diagnostic performance with staged FFR as reference, and a moderate diagnostic performance with staged iFR as reference.",
keywords = "FFR, QFR, STEMI, fractional flow reserve, iFR, instantaneous wave-free ratio",
author = "Martin Sejr-Hansen and Jelmer Westra and Troels Thim and Christiansen, {Evald H{\o}j} and Ashkan Eftekhari and Kristensen, {Steen Dalby} and Lars Jakobsen and Matthias G{\"o}tberg and Ole Fr{\o}bert and {van der Hoeven}, {Nina W} and Holm, {Niels Ramsing} and Michael Maeng",
note = "{\textcopyright} 2019 Wiley Periodicals, Inc.",
year = "2019",
month = nov,
day = "1",
doi = "10.1002/ccd.28208",
language = "English",
volume = "94",
pages = "686--692",
journal = "Catheterization and Cardiovascular Interventions",
issn = "1522-1946",
publisher = "JohnWiley & Sons, Inc.",
number = "5",

}

RIS

TY - JOUR

T1 - Quantitative flow ratio for immediate assessment of nonculprit lesions in patients with ST-segment elevation myocardial infarction-An iSTEMI substudy

AU - Sejr-Hansen, Martin

AU - Westra, Jelmer

AU - Thim, Troels

AU - Christiansen, Evald Høj

AU - Eftekhari, Ashkan

AU - Kristensen, Steen Dalby

AU - Jakobsen, Lars

AU - Götberg, Matthias

AU - Frøbert, Ole

AU - van der Hoeven, Nina W

AU - Holm, Niels Ramsing

AU - Maeng, Michael

N1 - © 2019 Wiley Periodicals, Inc.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - OBJECTIVES: We evaluated the diagnostic performance of quantitative flow ratio (QFR) assessment of nonculprit lesions (NCLs) based on acute setting angiograms obtained in patients with ST-segment elevation myocardial infarction (STEMI) with QFR, fractional flow reserve (FFR), and instantaneous wave-free ratio (iFR) in the staged setting as reference.BACKGROUND: QFR is an angiography-based approach for the functional evaluation of coronary artery lesions.METHODS: This was a post-hoc analysis of the iSTEMI study. NCLs were assessed with iFR in the acute setting and with iFR and FFR at staged (median 13 days) follow-up. Acute and staged QFR values were computed in a core laboratory based on the coronary angiography recordings. Diagnostic cut-off values were ≤0.80 for QFR and FFR, and ≤0.89 for iFR.RESULTS: Staged iFR and FFR data were available for 146 NCLs in 112 patients in the iSTEMI study. Among these, QFR analysis was feasible in 103 (71%) lesions assessed in the acute setting with a mean QFR value of 0.82 (IQR: 0.73-0.91). Staged QFR, FFR, and iFR were 0.80 (IQR: 0.70-0.90), 0.81 (IQR: 0.71-0.88), and 0.91 (IQR: 0.87-0.96), respectively. Classification agreement of acute and staged QFR was 93% (95%Cl: 87-99). The classification agreement of acute QFR was 84% (95%CI: 76-90) using staged FFR as reference and 74% (95%CI: 65-83) using staged iFR as reference.CONCLUSIONS: Acute QFR showed a very good diagnostic performance with staged QFR as reference, a good diagnostic performance with staged FFR as reference, and a moderate diagnostic performance with staged iFR as reference.

AB - OBJECTIVES: We evaluated the diagnostic performance of quantitative flow ratio (QFR) assessment of nonculprit lesions (NCLs) based on acute setting angiograms obtained in patients with ST-segment elevation myocardial infarction (STEMI) with QFR, fractional flow reserve (FFR), and instantaneous wave-free ratio (iFR) in the staged setting as reference.BACKGROUND: QFR is an angiography-based approach for the functional evaluation of coronary artery lesions.METHODS: This was a post-hoc analysis of the iSTEMI study. NCLs were assessed with iFR in the acute setting and with iFR and FFR at staged (median 13 days) follow-up. Acute and staged QFR values were computed in a core laboratory based on the coronary angiography recordings. Diagnostic cut-off values were ≤0.80 for QFR and FFR, and ≤0.89 for iFR.RESULTS: Staged iFR and FFR data were available for 146 NCLs in 112 patients in the iSTEMI study. Among these, QFR analysis was feasible in 103 (71%) lesions assessed in the acute setting with a mean QFR value of 0.82 (IQR: 0.73-0.91). Staged QFR, FFR, and iFR were 0.80 (IQR: 0.70-0.90), 0.81 (IQR: 0.71-0.88), and 0.91 (IQR: 0.87-0.96), respectively. Classification agreement of acute and staged QFR was 93% (95%Cl: 87-99). The classification agreement of acute QFR was 84% (95%CI: 76-90) using staged FFR as reference and 74% (95%CI: 65-83) using staged iFR as reference.CONCLUSIONS: Acute QFR showed a very good diagnostic performance with staged QFR as reference, a good diagnostic performance with staged FFR as reference, and a moderate diagnostic performance with staged iFR as reference.

KW - FFR

KW - QFR

KW - STEMI

KW - fractional flow reserve

KW - iFR

KW - instantaneous wave-free ratio

U2 - 10.1002/ccd.28208

DO - 10.1002/ccd.28208

M3 - Journal article

C2 - 30912257

VL - 94

SP - 686

EP - 692

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

SN - 1522-1946

IS - 5

ER -