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Comparison of Major Adverse Cardiac Events Between Instantaneous Wave-Free Rati...

Lee, J; Choi, K; Koo, B; Dehbi, H; Doh, J; Nam, C; Baptista, SB, et al.; The DEFINE-FLAIR Trial Investigators

IMPORTANCE: Invasive physiologic indices such as fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are used in clinical practice. Nevertheless, comparative prognostic outcomes of iFR-guided and FFR-guided treatment in patients with type 2 diabetes have not yet been fully investigated. OBJECTIVE: To compare 1-year clinical outcomes of iFR-guided or FFR-guided treatment in patients with and wi...


Predictive factors of discordance between the instantaneous wave-free ratio and...

Dérimay, F; Johnson, N; Zimmermann, F; Adjedj, J; Witt, N; Hennigan, B; Koo, B; Barbato, E; Esposito, G; Trimarco, B; Rioufol, G; Baptista, SB

OBJECTIVES: To identify clinical, angiographic and hemodynamic predictors of discordance between instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). BACKGROUND: The iFR was found to be non-inferior to the gold-standard FFR for guiding coronary revascularization, although it is discordant with FFR in 20% of cases. A better understanding of the causes of discordance may enhance application of t...


Continuum of Vasodilator Stress From Rest to Contrast Medium to Adenosine Hyper...

Johnson, N; Jeremias, A; Zimmermann, F; Adjedj, J; Witt, N; Hennigan, B; Koo, B; Maehara, A; Matsumura, M; Barbato, E; Esposito, G; Trimarco, B

OBJECTIVES: This study compared the diagnostic performance with adenosine-derived fractional flow reserve (FFR) ≤0.8 of contrast-based FFR (cFFR), resting distal pressure (Pd)/aortic pressure (Pa), and the instantaneous wave-free ratio (iFR). BACKGROUND: FFR objectively identifies lesions that benefit from medical therapy versus revascularization. However, FFR requires maximal vasodilation, usually achieved wit...


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