Use of the Instantaneous Wave-free Ratio or Fractional Flow Reserve in PCI

In this trial involving 2492 patients, coronary revascularization guided by iFR, as compared with fractional flow reserve-guided revascularization, was within the prespecified margin for noninferiority with respect to major adverse cardiac events. For the past 20 years, physiological measurements ob...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 376; no. 19; pp. 1824 - 1834
Main Authors: Davies, Justin E, Sen, Sayan, Dehbi, Hakim-Moulay, Al-Lamee, Rasha, Petraco, Ricardo, Nijjer, Sukhjinder S, Bhindi, Ravinay, Lehman, Sam J, Walters, Darren, Sapontis, James, Janssens, Luc, Vrints, Christiaan J, Khashaba, Ahmed, Laine, Mika, Van Belle, Eric, Krackhardt, Florian, Bojara, Waldemar, Going, Olaf, Härle, Tobias, Indolfi, Ciro, Niccoli, Giampaolo, Ribichini, Flavo, Tanaka, Nobuhiro, Yokoi, Hiroyoshi, Takashima, Hiroaki, Kikuta, Yuetsu, Erglis, Andrejs, Vinhas, Hugo, Canas Silva, Pedro, Baptista, Sérgio B, Alghamdi, Ali, Hellig, Farrel, Koo, Bon-Kwon, Nam, Chang-Wook, Shin, Eun-Seok, Doh, Joon-Hyung, Brugaletta, Salvatore, Alegria-Barrero, Eduardo, Meuwissen, Martijin, Piek, Jan J, van Royen, Niels, Sezer, Murat, Di Mario, Carlo, Gerber, Robert T, Malik, Iqbal S, Sharp, Andrew S.P, Talwar, Suneel, Tang, Kare, Samady, Habib, Altman, John, Seto, Arnold H, Singh, Jasvindar, Jeremias, Allen, Matsuo, Hitoshi, Kharbanda, Rajesh K, Patel, Manesh R, Serruys, Patrick, Escaned, Javier
Format: Journal Article
Language:English
Published: United States Massachusetts Medical Society 11.05.2017
Subjects:
Acute Coronary Syndrome - diagnostic imaging
Acute Coronary Syndrome - physiopathology
Aged
Angina Pectoris - diagnostic imaging
Angina Pectoris - physiopathology
Angioplasty
Cardiology
Cardiovascular disease
Cardiovascular Diseases - mortality
Clinical outcomes
Clinical trials
Coronary Angiography
Coronary artery
Coronary Stenosis - diagnostic imaging
Coronary Stenosis - physiopathology
Coronary Stenosis - therapy
Female
Follow-Up Studies
Fractional Flow Reserve, Myocardial
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - epidemiology
Patients
Percutaneous Coronary Intervention - methods
Retreatment
Severity of Illness Index
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Summary:In this trial involving 2492 patients, coronary revascularization guided by iFR, as compared with fractional flow reserve-guided revascularization, was within the prespecified margin for noninferiority with respect to major adverse cardiac events. For the past 20 years, physiological measurements obtained during invasive procedures have been used to guide coronary revascularization. Pioneering work supported the use of flow measurements to make safe decisions about revascularization, 1 , 2 but this approach was soon superseded by the use of fractional flow reserve (FFR), which measures pressure as a surrogate of flow to estimate the severity of stenosis. 3 – 5 FFR was successful largely because of its technical simplicity and because clinical trials showed that it was associated with improved clinical outcomes after percutaneous coronary intervention (PCI). 6 , 7 Consequently, FFR is now included in the appropriate-use criteria for . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa1700445