{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T06:08:39Z","timestamp":1780812519692,"version":"3.54.1"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T00:00:00Z","timestamp":1626220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The current pressure-based coronary diagnostic index, fractional flow reserve (FFR), has a limited efficacy in the presence of microvascular disease (MVD). To overcome the limitations of FFR, the objective is to assess the recently introduced pressure drop coefficient (CDP), a fundamental fluid dynamics-based combined pressure\u2013flow index.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We hypothesize that CDP will result in improved clinical outcomes in comparison to FFR. To test the hypothesis, chi-square test was performed to compare the percent major adverse cardiac events (%MACE) at 5 years between (a) FFR &amp;lt; 0.75 and CDP &amp;gt; 27.9 and (b) FFR &amp;lt; 0.80 and CDP &amp;gt; 25.4 groups using a prospective cohort study. Furthermore, Kaplan\u2013Meier survival curves were compared between the FFR and CDP groups. The results were considered statistically significant for <jats:italic>p<\/jats:italic> &amp;lt; 0.05. The outcomes of the CDP arm were presumptive as clinical decision was solely based on the FFR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For the complete patient group, the %MACE in the CDP &amp;gt; 27.9 group (10 out of 35, 29%) was lower in comparison to the FFR &amp;lt; 0.75 group (11 out of 20, 55%), and the difference was near significant (<jats:italic>p<\/jats:italic> = 0.05). The survival analysis showed a significantly higher survival rate (<jats:italic>p<\/jats:italic> = 0.01) in the CDP &amp;gt; 27.9 group (<jats:italic>n<\/jats:italic> = 35) when compared to the FFR &amp;lt; 0.75 group (<jats:italic>n<\/jats:italic> = 20). The results remained similar for the FFR = 0.80 cutoff. The comparison of the 5-year MACE outcomes with the 1-year outcomes for the complete patient group showed similar trends, with a higher statistical significance for a longer follow-up period of 5 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the MACE and survival analysis outcomes, CDP could possibly be an alternate diagnostic index for decision-making in the cardiac catheterization laboratory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:ext-link>www.ClinicalTrials.gov<\/jats:ext-link>, identifier NCT01719016.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphys.2021.689517","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T10:14:01Z","timestamp":1626257641000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Comparison Between 5- and 1-Year Outcomes Using Cutoff Values of Pressure Drop Coefficient and Fractional Flow Reserve for Diagnosing Coronary Artery Diseases"],"prefix":"10.3389","volume":"12","author":[{"given":"Rupak K.","family":"Banerjee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sruthi","family":"Ramadurai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreyash M.","family":"Manegaonkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marepalli B.","family":"Rao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sathyaprabha","family":"Rakkimuthu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed A.","family":"Effat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,7,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"999","DOI":"10.1016\/j.jcin.2017.03.006","article-title":"Discordance between fractional flow reserve and coronary flow reserve: insights from intracoronary imaging and physiological assessment.","volume":"10","author":"Ahn","year":"2017","journal-title":"JACC Cardiovasc. 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