Physiological Disease Pattern as Assessed by Pull Back Pressure Gradient Index in Vessels With Fractional Flow Reserve (FFR)/iFR Discordance
Authors' conclusion
The physiological pattern of CAD is an important influencing factor in FFR/iFR discordance.
Study context
- Population
- Patients with chronic coronary syndrome and ≥1 epicardial lesion with 40% to 90% diameter stenosis on invasive angiography, with analyzable FFR, iFR and QFR-derived PPGi355 patients
- Participants
- 390 patients
- Exposure
- FFR-/iFR+ vs FFR+/iFR- discordant vessels
- FFR+/iFR+n = 103
- FFR-/iFR+n = 27
- FFR+/iFR-n = 38reference
- FFR-/iFR-n = 222
- Outcome
- PPGi in discordant groups (FFR+/iFR- vs FFR-/iFR+)
Main finding
As reported in the abstract
PPGi
FFR-/iFR+
0.65
median · IQR 0.60–0.69
FFR+/iFR-
0.82
median · IQR 0.75–0.85
P < 0.001
Observational data: associations, not effects.
Further findings
Physiological pattern of CAD (focal PPGi ≥0.75 vs diffuse PPGi < 0.75) in discordant groups · pattern of CAD
P < 0.001
Predominantly focal disease FFR+/iFR- 76.3% [29 of 38]
Predominantly diffuse disease FFR-/iFR+ 96.3% [26 of 27]
FFR/iFR discordance, all vessels
- FFR disagreed with iFR
- 16.7% (65 of 390)
- Median PPGi (Q1-Q3), all vessels
- 0.75 (0.67-0.85)
- Predominantly focal disease (PPGi ≥0.75)
- 209 of 390 (53.6%)
- Predominantly diffuse disease (PPGi < 0.75)
- 181 of 390 (46.4%)
Original publication
Physiological Disease Pattern as Assessed by Pull Back Pressure Gradient Index in Vessels With FFR/iFR Discordance. JACC Cardiovasc Interv. Published 19 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it