Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes.
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Cook, Christopher M
Baptista, Sérgio B
Silva, Pedro Canas
Christiansen, Evald H
Di Mario, Carlo
Gerber, Robert T
Kharbanda, Rajesh K
Lehman, Sam J
Malik, Iqbal S
Nijjer, Sukhjinder S
Piek, Jan J
Seto, Arnold H
Sharp, Andrew S P
Van Belle, Eric
van Royen, Niels
Vrints, Christiaan J
Patel, Manesh R
Davies, Justin E
MetadataShow full item record
CitationJACC. Cardiovascular interventions 2018;11(15):1437-1449
AbstractThe aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p < 0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04).
DescriptionTo access publisher's full text version of this article click on the hyperlink below
- Clinical Events After Deferral of LAD Revascularization Following Physiological Coronary Assessment.
- Authors: Sen S, Ahmad Y, Dehbi HM, Howard JP, Iglesias JF, Al-Lamee R, Petraco R, Nijjer S, Bhindi R, Lehman S, Walters D, Sapontis J, Janssens L, Vrints CJ, Khashaba A, Laine M, Van Belle E, Krackhardt F, Bojara W, Going O, Härle T, Indolfi C, Niccoli G, Ribichini F, Tanaka N, Yokoi H, Takashima H, Kikuta Y, Erglis A, Vinhas H, Silva PC, Baptista SB, Alghamdi A, Hellig F, Koo BK, Nam CW, Shin ES, Doh JH, Brugaletta S, Alegria-Barrero E, Meuwissen M, Piek JJ, van Royen N, Sezer M, Di Mario C, Gerber RT, Malik IS, Sharp ASP, Talwar S, Tang K, Samady H, Altman J, Seto AH, Singh J, Jeremias A, Matsuo H, Kharbanda RK, Patel MR, Serruys P, Escaned J, Davies JE
- Issue date: 2019 Feb 5
- Clinical Outcomes According to Fractional Flow Reserve or Instantaneous Wave-Free Ratio in Deferred Lesions.
- Authors: Lee JM, Shin ES, Nam CW, Doh JH, Hwang D, Park J, Kim KJ, Zhang J, Ahn C, Koo BK
- Issue date: 2017 Dec 26
- Instantaneous Wave-Free Ratio (IFR)
- Authors: Soos MP, Gonzalez-Morales D, McComb D
- Issue date: 2019 Jan
- Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI.
- Authors: Götberg M, Christiansen EH, Gudmundsdottir IJ, Sandhall L, Danielewicz M, Jakobsen L, Olsson SE, Öhagen P, Olsson H, Omerovic E, Calais F, Lindroos P, Maeng M, Tödt T, Venetsanos D, James SK, Kåregren A, Nilsson M, Carlsson J, Hauer D, Jensen J, Karlsson AC, Panayi G, Erlinge D, Fröbert O, iFR-SWEDEHEART Investigators.
- Issue date: 2017 May 11
- Similarity and Difference of Resting Distal to Aortic Coronary Pressure and Instantaneous Wave-Free Ratio.
- Authors: Lee JM, Park J, Hwang D, Kim CH, Choi KH, Rhee TM, Tong Y, Park JJ, Shin ES, Nam CW, Doh JH, Koo BK
- Issue date: 2017 Oct 24