Photo Credit: Andrey Zhuravlev

The following is a summary of “Head-to-head comparison of two angiography-derived fractional flow reserve techniques in patients with high-risk acute coronary syndrome: A multicenter prospective study,” published in the March 2024 issue of Cardiology by Skalidis et al.

Researchers conducted a retrospective study to evaluate the performance of FFRangio and QFR, validated in stable coronary artery disease, by directly comparing them with invasive fractional flow reserve (FFR) in patients presenting with acute coronary syndromes (ACS).

They conducted this study as a subset of a larger prospective multicenter, single-arm investigation involving patients diagnosed with high-risk ACS, focusing on individuals with 30–70% stenosis assessed by FFR. FFRangio and QFR were independently calculated offline by two blinded operators and compared against FFR. The study’s two co-primary endpoints were comparing the Pearson correlation coefficient between FFRangio and QFR with FFR and assessing their inter-observer variability.

The results showed that among the 134 high-risk ACS-screened patients, 59 patients with 84 vessels underwent FFR measurements and were included in the study. The mean FFR value was 0.82 ± 0.40, with 32 (38%) ≤0.80. The mean FFRangio was 0.82 ± 0.20, and the mean QFR was 0.82 ± 0.30, with 27 (32%) and 25 (29%) being ≤0.80. The Pearson correlation coefficient was significantly better for FFRangio than QFR, with R values of 0.76 and 0.61, respectively (P=0.01). The inter-observer agreement was significantly better for FFRangio than QFR (0.86 vs 0.79, P<0.05). FFRangio demonstrated 91% sensitivity, 100% specificity, and 96.8% accuracy, while QFR exhibited 86.4% sensitivity, 98.4% specificity, and 93.7% accuracy.

Investigators concluded that FFRangio and QFR exhibited excellent diagnostic accuracy in high-risk ACS patients, with FFRangio showing a superior correlation with invasive FFR compared to QFR; however, larger validation studies are needed for further confirmation.

Source: internationaljournalofcardiology.com/article/S0167-5273(23)01798-9/fulltext#%20