# 5-jaars iFR versus FFR-geleide PCI: DEFINE-FLAIR/iFR-SWEDEHEART

*geplaatst 2022-03-15 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2021.12.030 · https://hartvaat.nl/2022/03/15/5-jaars-ifr-versus-ffr-geleide-pci-define-flair-ifr-swedeheart/*

5-jaarsresultaten van iFR versus FFR-geleide PCI. Langetermijnbevestiging van non-inferioriteit.

## English: 5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve.

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.

## Abstract (original, from the publication)

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).

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2021.12.030. Bijgewerkt 2026-07-03T13:28:46Z. 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.