Objectives The aim of this study was to evaluate the accuracy of the Multifunction CardioGram (MCG) in detecting the presence of functionally significant coronary ischaemia. Methods and results This prospective study evaluated the accuracy of the MCG, a new ECG analysis device used to diagnose ischaemic coronary artery disease (CAD). A consecutive 112 participants suspected to have CAD who were scheduled for elective coronary angiography (CAG) from October 2012 to December 2013 were examined. Their predictive values of relevant ischaemia were measured by MCG, standard ECG and Framingham Risk Score (FRS) and compared. Five levels of ischaemia based on CAG findings adjusted by fractional flow reserve (FFR) values and three levels of MCG score of high, borderline or low were used. The MCG (OR=2.67 (1.60 to 4.44), p<0.001) was the only test significantly associated with ischaemia level. The FFR values for individual MCG scores with low, borderline and high were 0.77 (0.70 to 0.86), 0.78 (0.71 to 0.82) and 0.69 (0.65 to 0.77), respectively, p=0.042. A high MCG score had a specificity of 90.4% (87.0% to 93.9%) in model 1 adjusted by FFR≤0.8 threshold and of 87.0% (83.2% to 90.8%) in model 2 adjusted by FFR≤0.75 threshold, and a negative predictive value of 82.5% (78.3% to 86.7%) in model 1 and of 83.8% (79.6% to 87.9%) in model 2 for the prediction of severe ischaemia. Conclusions The MCG showed high specificity with a high negative predictive value, suggesting that the MCG could be used not only to identify functionally significant ischaemia but to reduce unnecessary CAGs. Trial registration number UMIN ID: 000009992.
Introduction: Although identifying functional ischemia is important to decide revascularization, angiographic assessment alone is challenging in intermediate coronary stenosis. Previous studies have reported lesion-specific characteristics affected fractional flow reserve (FFR) values. However, the relationship between multiple lesion morphologies and FFR values has not been fully evaluated yet. Hypothesis: We hypothesized that cumulative impact of lesion complexity and lesion location affected FFR value as well as the degree of stenosis in intermediate stenotic coronary lesions. Methods: A total of 109 consecutive patients with 136 intermediate stenotic lesions (visual estimation 40%< diameter stenosis <70%) were assessed by quantitative coronary angiography, lesion-specific characteristics, and fractional flow reserve (FFR). According to the number of morphologies, lesion complexity was classified into 3 groups (mild-complex: 0 or 1 morphology, moderate-complex: 2 or 3 morphologies, and severe-complex: ...
