Coronary disease & ACSMeta-analysis
Instantaneous wave free ratio vs. fractional flow reserve and 5-year mortality: iFR SWEDEHEART and DEFINE FLAIR
- Study-level meta-analysis of randomised trials
- 2 RCTs (iFR-SWEDEHEART, DEFINE-FLAIR)
- reconstructed Kaplan-Meier data (ipdfc)
Authors' conclusion
Five-year all-cause mortality and MACE rates were increased with revascularization guided by iFR compared to FFR. Rates of unplanned revascularization and MI were equal in the two groups.
Study context
- Population
- Patients with intermediate epicardial artery stenosis2 RCTs
- Participants
- 2,254 vs 2,257
- Comparison
- iFR-guided vs fractional flow reserve (FFR)-guided revascularisation
- iFRn = 2,254
- FFRn = 2,257reference
- Outcome
- MACE and its components (all-cause death, MI, unplanned revascularisation)
- Follow-up
- 5 years
Pooled result
As reported in the abstract
5-year follow-up
| Group | Deaths | Major adverse cardiovascular events (MACE) | Unplanned revascularisation | Myocardial infarction (MI) |
|---|---|---|---|---|
| iFR | 188 (8.3%) | 484 (21.5%) | 235 (10.4%) | 123 (5.5%) |
| FFR | 143 (6.3%) | 420 (18.6%) | 241 (10.7%) | 123 (5.4%) |
- HR (95% CI), MACE, iFR vs FFR
- 1.18 [1.04; 1.34]
- HR (95% CI), all-cause mortality, iFR vs FFR
- 1.34 [1.08; 1.67]
- HR (95% CI), unplanned revascularisation, iFR vs FFR
- 0.99 [0.83; 1.19]
- HR (95% CI), MI, iFR vs FFR
- 1.02 [0.80; 1.32]
Further pooled results
Revascularisation deferred
P = 0.001
Original publication
Instantaneous wave free ratio vs. fractional flow reserve and 5-year mortality: iFR SWEDEHEART and DEFINE FLAIR. Eur Heart J. Published 27 August 2023. doi:10.1093/eurheartj/ehad582
Summarised from the published abstract; every number is checked against it