Functional Assessment of Coronary Artery Stenosis from Coronary Angiography and Computed Tomography: Angio-FFR vs. CT-FFR

This study was designed to compare the diagnostic performance of angio-FFR and CT-FFR for detecting hemodynamically significant coronary stenosis. Angio-FFR and CT-FFR were measured in 110 patients (139 vessels) with stable coronary disease using invasive FFR as the reference standard. On per-patient basis, angio-FFR was highly correlated with FFR (r =0.78, p < 0.001), while the correlation was moderate between CT-FFR and FFR (r =0.68, p < 0.001). Diagnostic accuracy, sensitivity, and specificity for angio-FFR were 94.6%, 91.4%, and 96.0%, respectively; and those of CT-FFR were 91.8%, 91.4%, and 92%, respectively. Bland-Altman analysis showed that angio-FFR had a larger average difference and a smaller root mean squared deviation than CT-FFR compared with FFR (-0.014 +/-.056 vs. 0.0003 +/- 0.072). Angio-FFR had a slightly higher AUC than that of CT-FFR (0.946 vs. 0.935, p =0.750). Angio-FFR and CT-FFR computed from coronary images could be accurate and efficient computational tools for detecting lesion-specific ischemia of coronary artery stenosis.

Automated summary

This study compares the diagnostic performance of angio-FFR and CT-FFR in detecting hemodynamically significant coronary stenosis. The correlation between angio-FFR and invasive FFR was highly significant, while the correlation between CT-FFR and invasive FFR was moderate. The diagnostic accuracy of angio-FFR was higher than that of CT-FFR.