Comparison of Coronary Angiographic-Derived and Intracoronary Imaging-Based Fractional Flow Reserve in Assessing Coronary Artery Stenosis Severity: A Systematic Review and Network Meta-Analysis.

IF 3.5 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of Evidence‐Based Medicine Pub Date : 2025-08-14 DOI:10.1111/jebm.70054

Jianchang Xie, Lu Ye, Jianmin Yang, Yigang Zhong, Peng Xu, Beibei Gao, Ningfu Wang, Xianhua Ye, Guoxin Tong, Jinyu Huang

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引用次数: 0

Abstract

Objective: This systematic review and network meta-analysis aimed to compare the accuracy of coronary angiographic-derived fractional flow reserve (Angio-FFR), optical coherence tomography (OCT)-FFR, and intravascular ultrasound (IVUS)-FFR in evaluating the severity of coronary artery stenosis.

Methods: PubMed, Embase, and Cochrane Library were searched from January 1, 2010 to April 1, 2024 for studies on the accuracy assessment of Angio-FFR, OCT-FFR, and IVUS-FFR. A network meta-analysis was performed with accuracy and analysis of variance models. The diagnostic performance was evaluated through absolute sensitivity (SEN), specificity (SPE), diagnostic dominance index (DDI), and diagnostic odds ratio (DOR), with the corresponding 95% confidence interval (CI).

Results: The analysis included 86 studies (16,552 lesions). Network meta-analysis showed that IVUS-FFR demonstrated the highest absolute SEN of 0.92 (0.91, 0.94), while OCT-FFR demonstrated the highest absolute SPE of 0.92 (0.91, 0.94). In comparison to Angio-FFR, intracoronary imaging (ICI)-FFR demonstrated superior diagnostic performance, with a DDI and DOR of 1.00 (95% CI: 0.99, 1.01) versus 0.96 (95% CI: 0.94, 0.98) and 79.18 (95% CI: 62.20, 92.35) versus 56.15 (95% CI: 52.86, 59.29), respectively. Furthermore, ICI-FFR demonstrated significantly greater overall accuracy than Angio-FFR, with a relative risk of 1.03 (95% CI: 1.01-1.04).

Conclusion: This comprehensive network meta-analysis establishes that ICI-FFR provides superior diagnostic performance for coronary artery stenosis assessment compared to Angio-FFR. These findings support the clinical value of ICI modalities in functional stenosis evaluation.

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冠状动脉造影和基于冠状动脉内成像的血流储备分数评估冠状动脉狭窄严重程度的比较：系统综述和网络荟萃分析。

目的：本系统综述和网络荟萃分析旨在比较冠状动脉造影衍生的分数血流储备（Angio-FFR）、光学相干断层扫描(OCT)-FFR和血管内超声(IVUS)-FFR在评估冠状动脉狭窄严重程度方面的准确性。方法：检索2010年1月1日至2024年4月1日PubMed、Embase和Cochrane图书馆，检索有关Angio-FFR、OCT-FFR和IVUS-FFR准确性评估的研究。网络元分析进行准确性和方差模型分析。通过绝对灵敏度（SEN）、特异性（SPE）、诊断优势指数（DDI）、诊断优势比（DOR）及相应的95%置信区间（CI）评价诊断效果。结果：分析包括86项研究（16,552个病变）。网络荟萃分析显示，IVUS-FFR的绝对SEN最高，为0.92 (0.91,0.94)，OCT-FFR的绝对SPE最高，为0.92（0.91,0.94）。与血管-FFR相比，冠状动脉内成像(ICI)-FFR表现出更优越的诊断性能，DDI和DOR分别为1.00 （95% CI: 0.99, 1.01）和0.96 (95% CI: 0.94, 0.98), 79.18 （95% CI: 62.20, 92.35）和56.15 （95% CI: 52.86, 59.29）。此外，CI- ffr的总体准确性明显高于Angio-FFR，相对危险度为1.03 （95% CI: 1.01-1.04）。结论：这一综合网络荟萃分析表明，与Angio-FFR相比，ICI-FFR在冠状动脉狭窄评估中具有更好的诊断性能。这些发现支持ICI模式在功能性狭窄评估中的临床价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Evidence‐Based Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

11.20

自引率

1.40%

发文量

期刊介绍： The Journal of Evidence-Based Medicine (EMB) is an esteemed international healthcare and medical decision-making journal, dedicated to publishing groundbreaking research outcomes in evidence-based decision-making, research, practice, and education. Serving as the official English-language journal of the Cochrane China Centre and West China Hospital of Sichuan University, we eagerly welcome editorials, commentaries, and systematic reviews encompassing various topics such as clinical trials, policy, drug and patient safety, education, and knowledge translation.