title: Characteristics of function-anatomy mismatch in patients with coronary artery disease.
abstract: OBJECTIVE
  Coronary lesions with mismatched functional and anatomical significance are not uncommon. We assessed the accuracy and predictors of mismatch between fractional flow reserve (FFR) and quantitative coronary angiography (QCA) analyses in patients with coronary lesions.
  
  
  METHODS
  A total of 643 lesions with pre-interventional FFR and QCA measurements were consecutively enrolled and divided into four groups using FFR ≤0.80 and percent diameter stenosis (%DS) ≥50% as cutoffs for functional and anatomical significance, respectively. Accordingly, FFR >0.80 and DS ≥50%, and FFR ≤0.80 and DS <50% defined false-positive (FP) and false-negative (FN) lesions, respectively.
  
  
  RESULTS
  Overall, 40.4% (260/643) of the lesions were mismatched, and 51.7% (218/414) and 18.3% (42/229) were FP and FN lesions, respectively. In a multivariate analysis, independent predictors of FP were non-left anterior descending artery location {odds ratio (OR), 0.36; 95% confidence interval (CI), 0.28-0.56; p<0.001}, shorter lesion length (OR, 0.96; 95% CI, 0.95-0.98; p<0.001), multi-vessel disease (OR, 0.47; 95% CI, 0.30-0.75; p=0.001), and larger minimal lumen diameter by QCA (OR, 2.88; 95% CI,1.65-5.00; p<0.001). Independent predictors of FN were multi-vessel disease (OR, 1.82; 95% CI, 1.24-5.27; p=0.048), aging (OR, 0.96; 95% CI, 0.93-0.99; p=0.034), smoking (OR, 0.36; 95% CI, 0.14-0.93; p=0.034), and smaller reference vessel diameter by QCA (OR, 0.30; 95% CI, 0.10-0.87; p=0.026).
  
  
  CONCLUSIONS
  A mismatch between FFR and angiographic lesion severity is not rare in patients with coronary artery disease; therefore, an angiography-guided evaluation could under- or over-estimate lesion severity in specific lesion subsets.
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea. ; Andong Medical Group, Cardiovascular Center, Andong, Korea.
authors.forename: Hyun-Ok
authors.initials: HO
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Chang-Wook
authors.initials: CW
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Yun-Kyeong
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyuck-Jun
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyoung-Seob
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Hyungseop
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: In-Sung
authors.initials: IS
authors.lastname: Chung
authors.affiliation: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors.forename: Joon-Hyung
authors.initials: JH
authors.lastname: Doh
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.affiliation: Andong Medical Group, Cardiovascular Center, Andong, Korea.
authors.forename: Dae-Woo
authors.initials: DW
authors.lastname: Hyun
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Hur
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Yoon-Nyun
authors.initials: YN
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
authors.forename: Kwon-Bae
authors.initials: KB
authors.lastname: Kim
keywords: Coronary angiography; Coronary artery disease; Fractional flow reserve, myocardial