AUTHOR=Banerjee Rupak K. , Ramadurai Sruthi , Manegaonkar Shreyash M. , Rao Marepalli B. , Rakkimuthu Sathyaprabha , Effat Mohamed A. 

TITLE=Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases

JOURNAL=Frontiers in Physiology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2021.689517

DOI=10.3389/fphys.2021.689517

ISSN=1664-042X

ABSTRACT=<sec><title>Background</title><p>The current pressure-based coronary diagnostic index, fractional flow reserve (FFR), has a limited efficacy in the presence of microvascular disease (MVD). To overcome the limitations of FFR, the objective is to assess the recently introduced pressure drop coefficient (CDP), a fundamental fluid dynamics-based combined pressure–flow index.</p></sec><sec><title>Methods</title><p>We hypothesize that CDP will result in improved clinical outcomes in comparison to FFR. To test the hypothesis, chi-square test was performed to compare the percent major adverse cardiac events (%MACE) at 5 years between (a) FFR &lt; 0.75 and CDP &gt; 27.9 and (b) FFR &lt; 0.80 and CDP &gt; 25.4 groups using a prospective cohort study. Furthermore, Kaplan–Meier survival curves were compared between the FFR and CDP groups. The results were considered statistically significant for <italic>p</italic> &lt; 0.05. The outcomes of the CDP arm were presumptive as clinical decision was solely based on the FFR.</p></sec><sec><title>Results</title><p>For the complete patient group, the %MACE in the CDP &gt; 27.9 group (10 out of 35, 29%) was lower in comparison to the FFR &lt; 0.75 group (11 out of 20, 55%), and the difference was near significant (<italic>p</italic> = 0.05). The survival analysis showed a significantly higher survival rate (<italic>p</italic> = 0.01) in the CDP &gt; 27.9 group (<italic>n</italic> = 35) when compared to the FFR &lt; 0.75 group (<italic>n</italic> = 20). The results remained similar for the FFR = 0.80 cutoff. The comparison of the 5-year MACE outcomes with the 1-year outcomes for the complete patient group showed similar trends, with a higher statistical significance for a longer follow-up period of 5 years.</p></sec><sec><title>Conclusion</title><p>Based on the MACE and survival analysis outcomes, CDP could possibly be an alternate diagnostic index for decision-making in the cardiac catheterization laboratory.</p></sec><sec><title>Clinical Trial Registration</title><p><ext-link ext-link-type="uri" xlink:href="http://www.ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.ClinicalTrials.gov</ext-link>, identifier NCT01719016.</p></sec>