Lots of interesting abstracts and cases were submitted for TCTAP 2024. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP A-035
Comparison of Nitroglycerin-Induced Pressure Ratio Drop and Resting Full-Cycle Ratio in Pressure Wire Study
By Chien-Boon Jong, Tsui-Shan Lu, Jia-Lang Xu, Jui-Cheng Kuo
Presenter
Chien-Boon Jong
Authors
Chien-Boon Jong1, Tsui-Shan Lu2, Jia-Lang Xu3, Jui-Cheng Kuo4
Affiliation
National Taiwan University Hospital Hsin-chu Hospital, Taiwan1, National Taiwan Normal University, Taiwan2, National Chung Hsing University, Taiwan3, National Taiwan University Hospital Hsin-chu Branch, Taiwan4
View Study Report
TCTAP A-035
FFR
Comparison of Nitroglycerin-Induced Pressure Ratio Drop and Resting Full-Cycle Ratio in Pressure Wire Study
Chien-Boon Jong1, Tsui-Shan Lu2, Jia-Lang Xu3, Jui-Cheng Kuo4
National Taiwan University Hospital Hsin-chu Hospital, Taiwan1, National Taiwan Normal University, Taiwan2, National Chung Hsing University, Taiwan3, National Taiwan University Hospital Hsin-chu Branch, Taiwan4
Background
Intracoronary nitroglycerin (NTG) injection is mandatory for evaluating physiological ischemia of the myocardium by FFR or non-hyperemic pressure ratio measurement. The acute drop in the ratio of the mean arterial pressure distal (Pd) to the stenosis and mean aortic pressure at the tip of the guiding catheter (Pa) after intracoronary NTG (NTG-Pd/Pa) has been shown to be an acceptable estimate of FFR.This study aimed to compare the diagnostic performance of NTG-Pd/Pa with that of the resting full-cycle ratio (RFR) to predict the binary results of the FFR.
Methods
A total of 202 vessels were included in this study. We determined the relationship between NTG-Pd/Pa and FFR. The optimal cutoff of NTG-Pd/Pa for predicting FFR≤0.8 was identified and validated in another prospective registry. We used McNemar’s test and the Delong method to compare the diagnostic efficiency of NTG-Pd/Pa versus RFR in predicting FFR≤0.8 in a pooled cohort.
Results
NTG-Pd/Pa was strongly correlated with FFR (r=0.945, p<0.001). The NTG-Pd/Pa cutoff for predicting FFR≤0.8 was 0.85 in both the derivation and validation cohorts. The receiver-operating characteristic area under the curve (AUC) value and accuracy in predicting FFR≤0.8 were higher for NTG-Pd/Pa than for RFR in the pooled cohort (AUC 0.97 vs 0.91, p<0.001; accuracy 91% vs 84%, p<0.001). The sensitivity and negative predictive values were also higher for NTG-Pd/Pa than for RFR (all p<0.05). The specificity and positive predictive value were high for both NTG-Pd/Pa and RFR; however, the difference was not statistically significant (all p>0.05).
Conclusion
NTG-Pd/Pa can be considered a novel index for the physiological assessment of coronary stenosis. The diagnostic performance of NTG-Pd/Pa may surpass that of the RFR in predicting the binary results of the FFR.