Accuracy of coronary computed tomography angiography-derived quantitative flow ratio for onsite assessment of coronary lesions
Authors' conclusion
The study met its prespecified primary endpoint of the diagnostic accuracy of CT-μFR in identifying patients with haemodynamically significant coronary stenosis. CT-μFR was non-inferior to ICA-derived μFR in vessels without extensive calcification.
Study context
- Population
- Patients with CAD with ≥1 lesion with 30–90% diameter stenosis on coronary computed tomography angiography (CCTA) and planned invasive coronary angiography (ICA) within 30 days
- Participants
- 260 patients706 vessels
- Comparison
- CT-μFR vs invasive standard
- Outcome
- Patient-level diagnostic accuracy of CT-μFR in identifying haemodynamically significant coronary stenosis (invasive standard: FFR ≤0.80, or μFR ≤0.80 when FFR not available)
Methodological detailsprospective, single-centre, blinded, Enrolled consecutively December 2020 to August 2023
- Prospective
- Single-centre
- Blinded
- Enrolled consecutively December 2020 to August 2023
Performance
As reported in the abstract
Patient-level diagnostic performance of CT-μFR
| Test or model | Accuracy | Sensitivity | Specificity | PPV | NPV | Positive likelihood ratio | Negative likelihood ratio |
|---|---|---|---|---|---|---|---|
| CT-μFR | 89.6% (95% CI: 85.9-93.4%) | 93.1% | 86.1% | 87.1% | 92.5% | 6.7 | 0.1 |
CT-μFR
Accuracy89.6% (95% CI: 85.9-93.4%)
Sensitivity93.1%
Specificity86.1%
PPV87.1%
NPV92.5%
Positive likelihood ratio6.7
Negative likelihood ratio0.1
- Accuracy significantly higher than prespecified target of 72.0%
- P < 0.001
Further findings
| Outcome | CT-μFR | μFR | Difference (%) (95% CI) | P value | |
|---|---|---|---|---|---|
| Vessel-level accuracy in vessels without extensive calcification (231 vessels investigated by FFR)CT-μFRvs μFRNon-inferior · non-inferiority verdict: non-inferior | 90.6% | 88.9% | 1.8 (−2.8 to 5.5) | P for non-inferiority < 0.001 | |
| −50510Difference, % (linear scale) |
Original publication
Accuracy of coronary computed tomography angiography-derived quantitative flow ratio for onsite assessment of coronary lesions. EuroIntervention. Published 21 October 2024. doi:10.
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