1. Machine-learning-based prediction of fractional flow reserve after percutaneous coronary intervention.
- Author
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Hamaya, Rikuta, Goto, Shinichi, Hwang, Doyeon, Zhang, Jinlong, Yang, Seokhun, Lee, Joo Myung, Hoshino, Masahiro, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Chen, Shao-Liang, Toth, Gabor G., Piroth, Zsolt, Hakeem, Abdul, Uretsky, Barry F., Hokama, Yohei, Tanaka, Nobuhiro, Lim, Hong-Seok, Ito, Tsuyoshi, and Matsuo, Akiko
- Subjects
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PERCUTANEOUS coronary intervention , *CORONARY angiography , *MACHINE learning , *RANK correlation (Statistics) , *STATISTICAL correlation - Abstract
Post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) reflects residual atherosclerotic burden and is associated with future events. How much post-PCI FFR can be predicted based on baseline basic information and the clinical relevance have not been investigated. We compiled a multicenter registry of patients undergoing pre- and post-PCI FFR. Machine-learning (ML) algorithms were designed to predict post-PCI FFR levels from baseline demographics, quantitative coronary angiography, and pre-PCI FFR. FFR deviation was defined as actual minus ML-predicted post-PCI FFR levels, and its association with incident target vessel failure (TVF) was evaluated. Median (IQR) pre- and post-PCI FFR values were 0.71 (0.61, 0.77) and 0.88 (0.84, 0.93), respectively. The Spearman correlation coefficient of the actual and predicted post-PCI FFR was 0.54 (95% CI: 0.52, 0.57). FFR deviation was non-linearly associated with incident TVF (HR [95% CI] with Q3 as reference: 1.65 [1.14, 2.39] in Q1, 1.42 [0.98, 2.08] in Q2, 0.81 [0.53, 1.26] in Q4, and 1.04 [0.69, 1.56] in Q5). A model with polynomial function of continuous FFR deviation indicated increasing TVF risk for FFR deviation ≤0 but plateau risk with FFR deviation >0. An ML-based algorithm using baseline data moderately predicted post-PCI FFR. The deviation of post-PCI FFR from the predicted value was associated with higher vessel-oriented event. [Display omitted] • A machine-learning algorithm moderately predicted post-PCI FFR. • Discrepancy of actual and predicted post-PCI FFR was associated with TVF. • No additional benefit would be expected by achieving higher than the predicted FFR. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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