Predictors of discordance between fractional flow reserve (FFR) and diastolic pressure ratio (dPR) in intermediate coronary lesions

• DOI: 10.1016/j.ijcha.2023.101217
• Publication Date: 2023-05-16T06:52:38Z
• Authors: Alessandra Scoccia; Tara Neleman; Annemieke C. Zied...; Frederik T.W. Gro...; Jurgen M R Ligthart; Wijnand K. den De...; Roberto Diletti; Jeroen Wilschut; Rutger Jan Nuis; Felix Zijlstra; Eric Boersma; Nicolas M Van Mie...; Joost Daemen
• Keywords: Fractional Flow Reserve; Concordance

Recently, non-hyperemic pressure ratios (NHPRs) have been validated as a reliable alternative to fractional flow reserve (FFR). However, discordance between FFR and NHPRs is observed in 20-25% of cases. The aim this study evaluate predictors diastolic Pressure ratio (dPR).PREDICT retrospective, single center, investigator-initiated including 813 patients (1092vessels) who underwent assessment intermediate coronary lesions (angiographic 30%-80% stenosis). dPR was calculated using individual waveforms dedicated software. Clinical, angiographic hemodynamic variables were compared with concordant discordant values.Median age 65 (IQR:59-73) years 70% male. Hemodynamically significant lesions, defined by ≤ 0.80, 0.89, identified 29.6% 30.3% cases, respectively. Overall, values 22.1% (17.4% the vessels). Discordance related FFR+/dPR- FFR-/dPR + 11.8% 10.3% patients, respectively.In case FFR-dPR discordance, higher prevalence left anterior descending arteries (70.5% vs. 53.1%, p < 0.001) mean both significantly lower (FFR 0.81 ± 0.05 vs 0.85 0.08, 0.001, 0.89 0.04 0.92 0.08,p vessels concordance. Following multivariable adjustment, delta (defined absolute difference measured cut-off value 0.89) turned out be only independent predictor (OR = 0.74, 95% CI 0.68-0.79, 0.001).Our suggests that FFR-to-dPR occurs approximately one-fifth patients. Absolute appears discordance.