The 5-year followup of the iFR-SWEDEHEART has confirmed the safety and efficacy of using either FFR or iFR to guide PCI in intermediate lesions.
The iFR-SWEDEHEART initial outcomes together with the DEFINE-FLAIR outcomes had started the debate around these two measuring strategies. The FFR requires adenosine, which results costly in addition to causing adverse events, while the iFR, measured in the diastolic wave free period, does not require hyperemia.
One-year outcomes had shown the non-inferiority of iFR, which had been seen by the vast majority in the community as an advantage of physiological assessments in general, vs. the superiority of one technique over the other.
The 5-year followup was interesting because the iFR arm had included more deferred lesions. There was 29.1% of functionally significant lesion in the iFR arm, while the FFR are had 36.8% (p<0.0001). Fewer treated lesions translated into fewer stenting with iFR.
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At 5 years, the combined events rate was 21.5% for iFR vs 19.9% for FFR, a non-significant difference. The subgroup analysis did not hold surprises with the same results in the general population.
Original Title: iFR-SWEDEHEART: Five-year outcomes of a randomized trial of iFR-guided vs. FFR-guided PCI.
Reference: Götberg M. et al. Presentado en el congreso TCT 2021.
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