{"id":"eebbb2e3848d","type":"article","url":"https://hartvaat.nl/2022/03/15/5-jaars-ifr-versus-ffr-geleide-pci-define-flair-ifr-swedeheart/","title":"5-jaars iFR versus FFR-geleide PCI: DEFINE-FLAIR/iFR-SWEDEHEART","title_en":"5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2021.12.030","source_url":"https://doi.org/10.1016/j.jacc.2021.12.030","authors":["Matthias Götberg","Karolina Berntorp","Rebecca Rylance","Evald H Christiansen","Troels Yndigegn","Ingibjörg J Gudmundsdottir","Sasha Koul","Lennart Sandhall","Mikael Danielewicz","Lars Jakobsen","Sven-Erik Olsson","Hans Olsson","Elmir Omerovic","Fredrik Calais","Pontus Lindroos","Michael Maeng","Dimitrios Venetsanos","Stefan K James","Amra Kåregren","Jörg Carlsson","Jens Jensen","Ann-Charlotte Karlsson","David Erlinge","Ole Fröbert"],"significance":7,"published":"2022-03-15","source_date":"2022-03-15","image":"","kennis":[],"congress":"","summary_en":"Five-year results confirmed that iFR-guided PCI maintains noninferior outcomes compared with FFR-guided PCI over long-term follow-up, providing sustained evidence for the adenosine-free physiological assessment as a standard approach.","created":"2026-07-03T10:29:39Z","updated":"2026-07-03T13:28:46Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"5-jaarsresultaten van iFR versus FFR-geleide PCI. Langetermijnbevestiging van non-inferioriteit.","abstract_original":"BACKGROUND: Instantaneous wave-free ratio (iFR) is a coronary physiology index used to assess the severity of coronary artery stenosis to guide revascularization. iFR has previously demonstrated noninferior short-term outcome compared to fractional flow reserve (FFR), but data on longer-term outcome have been lacking. OBJECTIVES: The purpose of this study was to investigate the prespecified 5-year follow-up of the primary composite outcome of all-cause mortality, myocardial infarction, and unplanned revascularization of the iFR-SWEDEHEART trial comparing iFR vs FFR in patients with chronic and acute coronary syndromes. METHODS: iFR-SWEDEHEART was a multicenter, controlled, open-label, registry-based randomized clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment. A total of 2,037 patients were randomized to undergo revascularization guided by iFR or FFR. RESULTS: No patients were lost to follow-up. At 5 years, the rate of the primary composite endpoint was 21.5% in the iFR group and 19.9% in the FFR group (HR: 1.09; 95% CI: 0.90-1.33). The rates of all-cause death (9.4% vs 7.9%; HR: 1.20; 95% CI: 0.89-1.62), nonfatal myocardial infarction (5.7% vs 5.8%; HR: 1.00; 95% CI: 0.70-1.44), and unplanned revascularization (11.6% vs 11.3%; HR: 1.02; 95% CI: 0.79-1.32) were also not different between the 2 groups. The outcomes were consistent across prespecified subgroups. CONCLUSIONS: In patients with chronic or acute coronary syndromes, an iFR-guided revascularization strategy was associated with no difference in the 5-year composite outcome of death, myocardial infarction, and unplanned revascularization compared with an FFR-guided revascularization strategy. (Evaluation of iFR vs FFR in Stable Angina or Acute Coronary Syndrome [iFR SWEDEHEART]; NCT02166736)."}