Evidence map›Paper›PMID 35041147›Full record

ArticleThe international journal of cardiovascular imaging2022

Characterization of quantitative flow ratio and fractional flow reserve discordance using doppler flow and clinical follow-up.

Jelmer Westra, Ashkan Eftekhari, Mick Renkens, Hernán Mejía-Rentería, Martin Sejr-Hansen, Valérie Stegehuis, Niels Ramsing Holm, Robert-Jan de Winter, Jan J Piek, Javier Escaned and 2 more

Registry-linked trialAbstract read
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In one paragraph

Article in The international journal of cardiovascular imaging, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01813435 (GLOBAL LEADERS), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01813435 phase3completednot on this map

GLOBAL LEADERS: A Clinical Study Comparing Two Forms of Anti-platelet Therapy After Stent Implantation

TypeinterventionalSponsorECRI bvRan2013 to 2018Enrolled15,991ConditionsCoronary Artery Disease (CAD)ArmsTicagrelor, Acetylsalicylic Acid, Clopidogrel
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Jelmer WestraDepartment of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Ashkan EftekhariDepartment of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Mick RenkensDepartment of Cardiology, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands.
Hernán Mejía-RenteríaDepartment of Cardiology, Hospital Clínico San Carlos, Madrid, Spain.
Martin Sejr-HansenDepartment of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Valérie StegehuisDepartment of Cardiology, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands.
Niels Ramsing HolmDepartment of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Robert-Jan de WinterDepartment of Cardiology, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands.
Jan J PiekDepartment of Cardiology, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands.
Javier EscanedDepartment of Cardiology, Hospital Clínico San Carlos, Madrid, Spain.
J J WykrzykowskaDepartment of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
Evald Høj ChristiansenDepartment of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark. evald.christiansen@dadlnet.dk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The physiological mechanisms of quantitative flow ratio and fractional flow reserve disagreement are not fully understood. We aimed to characterize the coronary flow and resistance profile of intermediate stenosed epicardial coronary arteries with concordant and discordant FFR and QFR. Post-hoc analysis of the DEFINE-FLOW study. Anatomical and Doppler-derived physiological parameters were compared for lesions with FFR+QFR- (n = 18) vs. FFR+QFR+ (n = 43) and for FFR-QFR+ (n = 34) vs. FFR-QFR- (n = 139). The association of QFR results with the two-year rate of target vessel failure was assessed in the proportion of vessels (n = 195) that did not undergo revascularization. Coronary flow reserve was higher [2.3 (IQR: 2.1-2.7) vs. 1.9 (IQR: 1.5-2.4)], hyperemic microvascular resistance lower [1.72 (IQR: 1.48-2.31) vs. 2.26 (IQR: 1.79-2.87)] and anatomical lesion severity less severe [% diameter stenosis 45.5 (IQR: 41.5-52.5) vs. 58.5 (IQR: 53.1-64.0)] for FFR+QFR- lesions compared with FFR+QFR+ lesions. In comparison of FFR-QFR+ vs. FFR-QFR- lesions, lesion severity was more severe [% diameter stenosis 55.2 (IQR: 51.7-61.3) vs. 43.4 (IQR: 35.0-50.6)] while coronary flow reserve [2.2 (IQR: 1.9-2.9) vs. 2.2 (IQR: 1.9-2.6)] and hyperemic microvascular resistance [2.34 (IQR: 1.85-2.81) vs. 2.57 (IQR: 2.01-3.22)] did not differ. The agreement and diagnostic performance of FFR using hyperemic stenosis resistance (> 0.80) as reference standard was higher compared with QFR and coronary flow reserve. Disagreement between FFR and QFR is partly explained by physiological and anatomical factors. Clinical Trials Registration https://www.clinicaltrials.gov ; Unique identifier: NCT01813435.

Indexed as

Coronary flow reserveCoronary physiologyFractional flow reserveQuantitative coronary angiography

Identifiers

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.