What is the angiography error when defining myocardial ischemia during percutaneous coronary interventions?

The angiography has been used as a reference standard to define coronary artery disease (CAD), although its limitations are well-known. The significance of the myocardial fractional flow reserve (FFR) in the assessment of CAD is well established. The aim of this study was to evaluate the accuracy of...

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Bibliographic Details
Published in:Arquivos brasileiros de cardiologia 2008-09, Vol.91 (3), p.162-184
Main Authors: Sant'Anna, Fernando Mendes, da Silva, Expedito Ribeiro, Batista, Leonardo Alves, Brito, Marcelo Bastos, Ventura, Fábio Machado, Ferraz, Haroldo Adans, Buczynski, Leonardo, Barrozo, Carlos Alberto Mussel, Pijls, Nico
Format: Article
Language:eng ; por
Subjects:
Angioplasty, Balloon, Coronary
Chi-Square Distribution
Coronary Angiography - standards
Coronary Stenosis - diagnosis
Coronary Stenosis - physiopathology
Coronary Stenosis - surgery
Female
Fractional Flow Reserve, Myocardial - physiology
Humans
Male
Middle Aged
Myocardial Ischemia - diagnosis
Myocardial Ischemia - physiopathology
Myocardial Ischemia - surgery
Severity of Illness Index
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Summary:The angiography has been used as a reference standard to define coronary artery disease (CAD), although its limitations are well-known. The significance of the myocardial fractional flow reserve (FFR) in the assessment of CAD is well established. The aim of this study was to evaluate the accuracy of angiography when defining ischemic lesions and its correlation with FFR. Two hundred and fifty consecutive patients (471 arteries) were included in this study. All stenoses >or= 50% at the angiography visual estimate (AVE) were assessed by FFR measurements. When FFR was < 0.75, stenting was performed; when FFR was >or= 0.75, no interventional treatment was carried out. Offline quantitative coronary angiography (QCA) was performed in all stenoses, which were divided in intermediate (< 70% - 327) and severe (125). The correlation coefficients between the diameter of the stenosis (%DS) and FFR and the accuracy of VA of the angiography when assessing ischemia were determined. FFR could be obtained in 452 lesions (96%). Mean %DS and FFR were 56 +/- 8% and 0.74 and 76 +/- 6% and 0.48 for moderate and severe stenoses, respectively. Concordance between QCA and FFR was poor, especially in intermediate stenoses (Spearman's rho = - 0.33, p
ISSN:1678-4170
DOI:10.1590/S0066-782X2008001500007