Characteristics of Function-Anatomy Mismatch in Patients with Coronary Artery Disease.
10.4070/kcj.2014.44.6.394
- Author:
Hyun Ok CHO
1
;
Chang Wook NAM
;
Yun Kyeong CHO
;
Hyuck Jun YOON
;
Hyoung Seob PARK
;
Hyungseop KIM
;
In Sung CHUNG
;
Joon Hyung DOH
;
Bon Kwon KOO
;
Dae Woo HYUN
;
Seung Ho HUR
;
Yoon Nyun KIM
;
Kwon Bae KIM
Author Information
1. Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. ncwcv@dsmc.or.kr
- Publication Type:Original Article
- Keywords:
Fractional flow reserve, myocardial;
Coronary angiography;
Coronary artery disease
- MeSH:
Aging;
Arteries;
Constriction, Pathologic;
Coronary Angiography;
Coronary Artery Disease*;
Fractional Flow Reserve, Myocardial;
Humans;
Multivariate Analysis;
Smoke;
Smoking
- From:Korean Circulation Journal
2014;44(6):394-399
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Coronary lesions with mismatched functional and anatomical significance are not uncommon. We assessed the accuracy and predictors of mismatch between fractional flow reserve (FFR) and quantitative coronary angiography (QCA) analyses in patients with coronary lesions. SUBJECTS AND METHODS: A total of 643 lesions with pre-interventional FFR and QCA measurements were consecutively enrolled and divided into four groups using FFR < or =0.80 and percent diameter stenosis (%DS) > or =50% as cutoffs for functional and anatomical significance, respectively. Accordingly, FFR >0.80 and DS > or =50%, and FFR < or =0.80 and DS <50% defined false-positive (FP) and false-negative (FN) lesions, respectively. RESULTS: Overall, 40.4% (260/643) of the lesions were mismatched, and 51.7% (218/414) and 18.3% (42/229) were FP and FN lesions, respectively. In a multivariate analysis, independent predictors of FP were non-left anterior descending artery location {odds ratio (OR), 0.36; 95% confidence interval (CI), 0.28-0.56; p<0.001}, shorter lesion length (OR, 0.96; 95% CI, 0.95-0.98; p<0.001), multi-vessel disease (OR, 0.47; 95% CI, 0.30-0.75; p=0.001), and larger minimal lumen diameter by QCA (OR, 2.88; 95% CI,1.65-5.00; p<0.001). Independent predictors of FN were multi-vessel disease (OR, 1.82; 95% CI, 1.24-5.27; p=0.048), aging (OR, 0.96; 95% CI, 0.93-0.99; p=0.034), smoking (OR, 0.36; 95% CI, 0.14-0.93; p=0.034), and smaller reference vessel diameter by QCA (OR, 0.30; 95% CI, 0.10-0.87; p=0.026). CONCLUSION: A mismatch between FFR and angiographic lesion severity is not rare in patients with coronary artery disease; therefore, an angiography-guided evaluation could under- or over-estimate lesion severity in specific lesion subsets.
