Coronary disease & ACSSecondary analysis
Fractional Flow Reserve and Instantaneous Wave-Free Ratio as Predictors of the Placebo-Controlled Response to Percutaneous Coronary Intervention in Stable Coronary Artery Disease
- Secondary analysis of the ORBITA-2 randomised trial
- placebo-controlled
- blinded
- Bayesian proportional odds modelling
Authors' conclusion
Physiological stenosis severity, as measured by FFR and iFR, predicts placebo-controlled angina relief from PCI.
Study context
- Population
- Patients with angina, ischaemia and stable CAD, anti-anginal medications stoppedinvasive physiology data available
- Participants
- 279 patients
- Comparison
- Percutaneous coronary intervention (PCI) vs placebo, by fractional flow reserve (FFR) and iFR
- PCIn = 140
- Placebon = 139reference
- Primary endpoint
- Placebo-controlled improvement in angina symptom score with PCI, predicted by FFR and iFR (continuous)
- Follow-up
- 12-week blinded
Primary result
As reported in the abstract
Angina symptom score, lower vs upper quartile of physiology
Odds ratio (95% CrI)
FFR 0.46 (lower quartile) vs FFR 0.73 (upper quartile)
2.01(1.79–2.26)
iFR 0.50 (lower quartile) vs iFR 0.86 (upper quartile)
2.13(1.87–2.45)
Further findings
Baseline physiology
- Median FFR (IQR)
- 0.60 (0.46-0.73)
- Median iFR (IQR)
- 0.76 (0.50-0.86)
Rose angina and Rose nonangina (subgroups)
- Relationship between benefit and physiology seen in both Rose angina and Rose nonangina
Original publication
Fractional Flow Reserve and Instantaneous Wave-Free Ratio as Predictors of the Placebo-Controlled Response to Percutaneous Coronary Intervention in Stable Coronary Artery Disease. Circulation. Published 27 October 2024. doi:10.1161/circulationaha.124.072281
Summarised from the published abstract; every number is checked against it