TY  - BOOK
AU  - Swymelar, Stacy
AU  - Torguson, Rebecca
AU  - Waksman, Ron
TI  - FIRST: Fractional Flow Reserve and Intravascular  Ultrasound Relationship Study
SN  - 0735-1097
PY  - 2013///
KW  - *Coronary Disease/di [Diagnosis]
KW  - *Fractional Flow Reserve, Myocardial/ph  [Physiology]
KW  - *Ultrasonography, Interventional
KW  - Coronary Angiography
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Prospective Studies
KW  - Registries
KW  - MedStar Health Research Institute
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
KW  - Multicenter Study
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 1995 -  present, Available in print through MWHC library:1999-2007
N2  - BACKGROUND: FFR is considered the gold standard  for assessing intermediate coronary lesions. Measurements of  <=0.8 are considered clinically significant and indicative  of physiological ischemia; CONCLUSIONS: Anatomic measurements by IVUS show a  moderate correlation with the FFR values. The optimal cutoff  for an MLA to FFR <0.8 is vessel dependent. Plaque  morphology characteristics do not correlate with FFR. The  utility of IVUS MLA as an alternative to FFR to guide  intervention in intermediate lesions may be limited in  accuracy and should be tested clinically. (Fractional Flow  Reserve and Intravascular Ultrasound Relationship Study  [FIRST]; NCT01153555). Copyright  2013 American College of  Cardiology Foundation. Published by Elsevier Inc. All rights  reserved; METHODS: FIRST is a multicenter, prospective,  international registry of patients with intermediate  coronary lesions, defined as 40% to 80% stenosis by  angiography. In total, 350 patients (367 lesions) were  enrolled at 10 U.S. and European sites. Patients were  followed through hospital discharge; OBJECTIVES: FIRST (Fractional Flow Reserve and  Intravascular Ultrasound Relationship Study) aimed to  determine the optimal minimum lumen area (MLA) by  intravascular ultrasound (IVUS) that correlates with  fractional flow reserve (FFR) and to assess the correlation  between virtual histology IVUS and FFR for intermediate  coronary lesions; RESULTS: Overall, an MLA <3.07 mm (64.0%  sensitivity, 64.9% specificity, area under curve [AUC] =  0.65) was the best threshold value for identifying FFR <0.8.  The accuracy improved when reference vessel-specific  analyses were performed. An MLA <2.4 mm (AUC = 0.66) was  best for reference vessel diameters <3.0 mm, an MLA <2.7 mm  (AUC = 0.71) for reference vessel diameters of 3.0 to 3.5  mm, and an MLA <3.6 mm (AUC = 0.68) for reference vessel  diameters >3.5 mm. FFR correlated with plaque burden (r =  -0.220, p < 0.001) but not with other plaque morphology
UR  - http://dx.doi.org/10.1016/j.jacc.2012.12.012
ER  -