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DISCOVER FLOW trial - Summary & Results

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A prospective multicenter study to determine the diagnostic performance of noninvasive fractional flow reserve (FFRCT) ws invasively measured fractional flow reserve (FFR)

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DISCOVER FLOW trial - Summary & Results

  1. 1. DISCOVER FLOW (Diagnosis of ischemia-causing stenoses obtained via non-invasive fractional flow reserve)
  2. 2. DISCOVER FLOW (Diagnosis of ischemia-causingstenoses obtained via non-invasive fractional flow reserve)Bon-Kwon Koo (Seoul National University Hospital, Korea)EuroPCR 2011• Objective: A prospective multicenter study to determine the diagnostic performance of noninvasive fractional flow reserve (FFRCT) vs invasively measured fractional flow reserve (FFR)• Patients and treatment: Patients with stenosis in a major epicardial coronary artery ≥2 mm identified by CT angiography underwent invasive angiography with FFR (lesion-specific ischemia defined as an FFR <0.80) CT angiograms were then mapped using the noninvasive FFRCT technology Noninvasive computed FFRCT values were then compared with those of FFR actually obtained in the patients
  3. 3. DISCOVER FLOW: Results• Noninvasive computed FFRCT values were found to yield nearly identical results to FFR, with a very high degree of correlation• Looking at the CT angiograms alone, without the computational FFR, the scans scored well for sensitivity and negative predictive value but had lower scores, in the range of 40 to 60, for specificity, positive predictive value, and overall accuracy• FFRCT produced sensitivity and negative predictive value scores similar to those of CT alone but much higher scores—in the 80s—for specificity and positive predictive value• Overall accuracy score was increased by 25% with the FFRCT values
  4. 4. DISCOVER FLOW: Commentary*"This noninvasive all-in-one technology may reduce unnecessary invasivecoronary angiography and revascularization procedures." - Dr Bon-Kwon Koo"[FFR and other imaging tests can] distract from the overall picture and leavebehind unfinished work." - Dr Bernhard Meier"We should remember that these computerized models cannot substitute for clinicaljudgment. When you have a patient with angina and a 70% lesion, you feelcompelled to intervene, regardless of the FFR results." - Dr Ron Waksman*All comments from Adding function to CTA with "noninvasive FFR" ups accuracy, may cutprocedures: DISCOVER FLOW (http://www.theheart.org/article/1227905.do)
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