Concordance between vessel‐specific and vascular territory coronary functional assessment: A comparison of quantitative flow ratio and myocardial perfusion scintigraphy
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2024
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| author | Luciano de Moura Santos Carlos M. Campos Hector Manuel Garcia‐Garcia Roger Renault Godinho Maria Antonieta Albanez Medeiros Lopes Vinícius Bocchino Seleme Rafael Silva Côrtes Guilherme de Albuquerque Cavalcanti Mendes Vitor Emer Egypto Rosa Neuza Helena Moreira Lopes Fábio Sândoli de Brito Junior Alexandre Antônio Cunha Abizaid |
| author_facet | Luciano de Moura Santos Carlos M. Campos Hector Manuel Garcia‐Garcia Roger Renault Godinho Maria Antonieta Albanez Medeiros Lopes Vinícius Bocchino Seleme Rafael Silva Côrtes Guilherme de Albuquerque Cavalcanti Mendes Vitor Emer Egypto Rosa Neuza Helena Moreira Lopes Fábio Sândoli de Brito Junior Alexandre Antônio Cunha Abizaid Luciano de Moura Santos Carlos M. Campos Hector Manuel Garcia‐Garcia Roger Renault Godinho Maria Antonieta Albanez Medeiros Lopes Vinícius Bocchino Seleme Rafael Silva Côrtes Guilherme de Albuquerque Cavalcanti Mendes Vitor Emer Egypto Rosa Neuza Helena Moreira Lopes Fábio Sândoli de Brito Junior Alexandre Antônio Cunha Abizaid |
| collection | Wiley Open Access |
| contents | Concordance between vessel‐specific and vascular territory coronary functional assessment: A comparison of quantitative flow ratio and myocardial perfusion scintigraphy Luciano de Moura Santos Carlos M. Campos Hector Manuel Garcia‐Garcia Roger Renault Godinho Maria Antonieta Albanez Medeiros Lopes Vinícius Bocchino Seleme Rafael Silva Côrtes Guilherme de Albuquerque Cavalcanti Mendes Vitor Emer Egypto Rosa Neuza Helena Moreira Lopes Fábio Sândoli de Brito Junior Alexandre Antônio Cunha Abizaid Catheterization and Cardiovascular Interventions AbstractBackgroundQuantitative flow ratio (QFR) and myocardial perfusion scintigraphy (MPS) are utilized for assessing coronary artery disease (CAD) significance. We aimed to analyze their concordance and prognostic impact.AimsWe aimed to analyze the concordance between QFR and MPS and their risk stratification.MethodsPatients with invasive coronary angiography and MPS were categorized as concordant if QFR ≤ 0.80 and summed difference score (SDS) ≥ 4 or if QFR > 0.80 and SDS < 4; otherwise, they were discordant. Concordance was classified by coronary territory involvement: total (three territories), partial (two territories), poor (one territory), and total discordance (zero territories). Leaman score assessed coronary atherosclerotic burden.Results2010 coronary territories (670 patients) underwent joint QFR and MPS analysis. MPS area under the curve for QFR ≤ 0.80 was 0.637. Concordance rates were total (52.5%), partial (29.1%), poor (15.8%), and total discordance (2.6%). Most concordance occurred in patients without significant CAD or with single‐vessel disease (89.5%), particularly without MPS perfusion defects (91.5%). Leaman score (odds ratio [OR]: 0.839, 95% confidence interval [CI]: 0.805–0.875, p < 0.001) and MPS perfusion defect (summed stress score [SSS] ≥ 4) (OR: 0.355, 95% CI: 0.211–0.596, p < 0.001) were independent predictors for discordance. After 1400 days, no significant difference in death/myocardial infarction was observed based on MPS assessment, but Leaman score, functional Leaman score, and average QFR identified higher risk patients.ConclusionsMPS showed good overall accuracy in assessing QFR significance but substantial discordance existed. Predictors for discordance included higher atherosclerotic burden and MPS perfusion defects (SSS ≥ 4). Leaman score, QFR‐based functional Leaman score, and average QFR provided better risk stratification for all‐cause death and myocardial infarction than MPS. 10.1002/ccd.31021 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/ccd.31021 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_ccd_31021 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2024 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Concordance between vessel‐specific and vascular territory coronary functional assessment: A comparison of quantitative flow ratio and myocardial perfusion scintigraphy Luciano de Moura Santos Carlos M. Campos Hector Manuel Garcia‐Garcia Roger Renault Godinho Maria Antonieta Albanez Medeiros Lopes Vinícius Bocchino Seleme Rafael Silva Côrtes Guilherme de Albuquerque Cavalcanti Mendes Vitor Emer Egypto Rosa Neuza Helena Moreira Lopes Fábio Sândoli de Brito Junior Alexandre Antônio Cunha Abizaid Catheterization and Cardiovascular Interventions Concordance between vessel‐specific and vascular territory coronary functional assessment: A comparison of quantitative flow ratio and myocardial perfusion scintigraphy Luciano de Moura Santos Carlos M. Campos Hector Manuel Garcia‐Garcia Roger Renault Godinho Maria Antonieta Albanez Medeiros Lopes Vinícius Bocchino Seleme Rafael Silva Côrtes Guilherme de Albuquerque Cavalcanti Mendes Vitor Emer Egypto Rosa Neuza Helena Moreira Lopes Fábio Sândoli de Brito Junior Alexandre Antônio Cunha Abizaid Catheterization and Cardiovascular Interventions AbstractBackgroundQuantitative flow ratio (QFR) and myocardial perfusion scintigraphy (MPS) are utilized for assessing coronary artery disease (CAD) significance. We aimed to analyze their concordance and prognostic impact.AimsWe aimed to analyze the concordance between QFR and MPS and their risk stratification.MethodsPatients with invasive coronary angiography and MPS were categorized as concordant if QFR ≤ 0.80 and summed difference score (SDS) ≥ 4 or if QFR > 0.80 and SDS < 4; otherwise, they were discordant. Concordance was classified by coronary territory involvement: total (three territories), partial (two territories), poor (one territory), and total discordance (zero territories). Leaman score assessed coronary atherosclerotic burden.Results2010 coronary territories (670 patients) underwent joint QFR and MPS analysis. MPS area under the curve for QFR ≤ 0.80 was 0.637. Concordance rates were total (52.5%), partial (29.1%), poor (15.8%), and total discordance (2.6%). Most concordance occurred in patients without significant CAD or with single‐vessel disease (89.5%), particularly without MPS perfusion defects (91.5%). Leaman score (odds ratio [OR]: 0.839, 95% confidence interval [CI]: 0.805–0.875, p < 0.001) and MPS perfusion defect (summed stress score [SSS] ≥ 4) (OR: 0.355, 95% CI: 0.211–0.596, p < 0.001) were independent predictors for discordance. After 1400 days, no significant difference in death/myocardial infarction was observed based on MPS assessment, but Leaman score, functional Leaman score, and average QFR identified higher risk patients.ConclusionsMPS showed good overall accuracy in assessing QFR significance but substantial discordance existed. Predictors for discordance included higher atherosclerotic burden and MPS perfusion defects (SSS ≥ 4). Leaman score, QFR‐based functional Leaman score, and average QFR provided better risk stratification for all‐cause death and myocardial infarction than MPS. 10.1002/ccd.31021 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Concordance between vessel‐specific and vascular territory coronary functional assessment: A comparison of quantitative flow ratio and myocardial perfusion scintigraphy |
| topic | Catheterization and Cardiovascular Interventions |
| url | https://onlinelibrary.wiley.com/doi/10.1002/ccd.31021 |