Deferred vs. performed revascularization for coronary stenosis with grey-zone fractional flow reserve values: data from the IRIS-FFR registry
Authors' conclusion
For coronary stenosis with grey-zone FFR, revascularization was not associated with better clinical outcomes. The higher likelihood of periprocedural MI with revascularization was offset by the higher likelihood of TVR with deferral.
Study context
- Population
- Native coronary stenosis with grey-zone fractional flow reserve (FFR) values (0.75–0.80), IRIS-FFR registry
- Participants
- 1,334 stenoses
- Exposure
- Deferred vs performed revascularization
- Deferredn = 683
- Performedn = 651reference
- Outcome
- Composite of:
- Death
- Target-vessel MI
- TVR
- Follow-up
- Median 2.9 years (IQR 1.5-4.1 years)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Adjusted hazard ratio
1.05
95% CI 0.67–1.66
P = 0.79
Events by group
Deferredvs Performed
aHR 1.05 (95% CI 0.67–1.66); P = 0.79
Observational data: associations, not effects.
Further findings
Overall mortality · median follow-up 2.9 years
- Did not differ between the groups (deferred vs performed)
- 2.5% vs. 2.0%
- aHR
- 0.82, 95% CI 0.34-2.00; P = 0.66
- Adjusted HR
Spontaneous myocardial infarction (MI) · median follow-up 2.9 years
- Did not differ between the groups (deferred vs performed)
- 0.7% vs. 0.5%
- aHR
- 1.85, 95% CI 0.35-9.75; P = 0.47
- Adjusted HR
MI (mainly periprocedural) · median follow-up 2.9 years
- Significantly higher in the performed group (deferred vs performed)
- 0.7% vs. 3.2%
- aHR
- 0.27, 95% CI 0.09-0.80; P = 0.02
- Adjusted HR
- Mainly because of a higher risk of periprocedural MI
Target vessel revascularization (TVR) · median follow-up 2.9 years
- Significantly higher in the deferred group (deferred vs performed)
- 5.7% vs. 3.7%
- aHR
- 2.17, 95% CI 1.17-4.02; P = 0.01
- Adjusted HR
Original publication
Deferred vs. performed revascularization for coronary stenosis with grey-zone fractional flow reserve values: data from the IRIS-FFR registry. Eur Heart J. Published 24 February 2018. doi:10.
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