Coronary disease & ACSCohort study
Contrasting Prognostic Value of Discordance Between Resting Distal-to-Aortic Coronary Pressure Ratio and Fractional Flow Reserve in Coronary Artery Disease
- prospective IRIS-FFR registry
Authors' conclusion
FFR predicts vessel-specific coronary events, whereas resting Pd/Pa is associated with overall survival. The contrasting prognostic value of discordant lesions underscores the clinical importance of a complementary assessment using both resting and hyperemic coronary physiological indices.
Study context
- Population
- Medically managed coronary lesions with fractional flow reserve (FFR) and resting Pd/Pa measurementslesions in 7376 patients treated medically
- Participants
- 9,737 participants
- Exposure
- Resting Pd/Pa >0.93 and FFR ≤0.80 vs Resting Pd/Pa ≤0.93 and FFR >0.80
- Outcome
- Target-vessel failure, including target-vessel myocardial infarction and target-vessel revascularization, with death from any cause considered as a competing risk
- Follow-up
- 5-year
Main finding
As reported in the abstract
Adjusted hazard ratio
1.67
95% CI 1.09–2.55
P = 0.020
Resting Pd/Pa >0.93 and FFR ≤0.80 vs Resting Pd/Pa ≤0.93 and FFR >0.80
adjusted hazard ratio 1.67 (95% CI 1.09–2.55); P = 0.020
Observational data: associations, not effects.
Secondary outcomes
| Outcome | adjusted hazard ratio (95% CI) | P value | |
|---|---|---|---|
| Death from any cause (key secondary outcome) · lower risk with resting Pd/Pa >0.93 and FFR ≤0.80 | 0.23 (0.11–0.52) | P < 0.001 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Discordance between resting Pd/Pa and FFR
- Discordance present in lesions treated medically
- 15.91%
- Discordant lesions
- n=1549
Reduction in target-vessel failure with revascularization
- Observed only in the group with resting Pd/Pa >0.93 and FFR ≤0.80
Original publication
Contrasting Prognostic Value of Discordance Between Resting Distal-to-Aortic Coronary Pressure Ratio and Fractional Flow Reserve in Coronary Artery Disease. Circ Cardiovasc Interv. Published 24 September 2026. doi:10.1161/circinterventions.126.016865
Summarised from the published abstract; every number is checked against it