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Medicine (Baltimore). 2016 Sep;95(36):e4774. doi: 10.1097/MD.0000000000004774.

Diagnostic performance of instantaneous wave-free ratio for the evaluation of coronary stenosis severity confirmed by fractional flow reserve: A PRISMA-compliant meta-analysis of randomized studies.

Author information

1
aDepartment of Cardiology, Xijing Hospital bDepartment of Health Statistics, Faculty of Preventive Medicine cDepartment of Cardiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China.

Abstract

BACKGROUND:

The instantaneous wave-free ratio (iFR) is a new vasodilator-free index of coronary stenosis severity. The aim of this meta-analysis is to assess the diagnostic performance of iFR for the evaluation of coronary stenosis severity with fractional flow reserve as standard reference.

METHODS:

We searched PubMed, EMBASE, CENTRAL, ProQuest, Web of Science, and International Clinical Trials Registry Platform (ICTRP) for publications concerning the diagnostic value of iFR. We used a random-effects covariate to synthesize the available data of sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnostic odds ratio (DOR). Overall test performance was summarized by the summary receiver operating characteristic curve (sROC) and the area under the curve (AUC).

RESULTS:

Eight studies with 1611 subjects were included in the meta-analysis. The pooled sensitivity, specificity, LR+, LR-, and DOR for iFR were respectively 73.3% (70.1-76.2%), 86.4% (84.3-88.3%), 5.71 (4.43-7.37), 0.29 (0.22-0.38), and 20.54 (16.11-26.20). The area under the summary receiver operating characteristic curves for iFR was 0.8786. No publication bias was identified.

CONCLUSION:

The available evidence suggests that iFR may be a new, simple, and promising technology for coronary stenosis physiological assessment.

PMID:
27603377
PMCID:
PMC5023900
DOI:
10.1097/MD.0000000000004774
[Indexed for MEDLINE]
Free PMC Article

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