Instantaneous wave-free ratio (iFR®) to determine hemodynamically significant coronary stenosis: A comprehensive review

doi:10.4330/wjc.v10.i12.267

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Dec 26, 2018 (publication date) through Jul 27, 2024

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World Journal of Cardiology

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1949-8462

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World J Cardiol. Dec 26, 2018; 10(12): 267-277
Published online Dec 26, 2018. doi: 10.4330/wjc.v10.i12.267

Table 1 Significant instantaneous wave-free ratio-(iFR^®)-studies

	Advise	Verify	Clarify	*Park et al[39]*	Resolve	Advise in practice	*Indolfi et al[42]*	ADVISE II	*Harle et al[44]*	*Van de Hoef et al[45]*	DEFINE-FLAIR	iFR^®-SWEDHEART
First author journal and year of Publication	Sen et al[18]. J Am Coll Cardiol 2012	Berry et al[37]. J Am Coll Cardiol 2013	Sen et al[38]. J Am Coll Cardiol 2013	Park et al[39]. Int J Cardiol 2013	Jeremias et al[40]. J Am Coll Cardiol 2014	Petraco et al[41]. Am Heart J 2014	Indolfi et al[42]. Int J Cardiol 2015	Escaned et al[43]. J Am Coll Cardiol-Intv 2015	Harle et al[44]. Int J Cardiol 2015	Van de Hoef et al[45]. Euro-Intervention 2015	Davies et al[19]. N Engl J Med 2017	Götberg et al[20]. N Engl J Med 2017
Study design	PC, multicenter, non-randomized	PC, multicenter, non-randomized	PC, multicenter	PC, multicenter, non-randomized	RS, multicenter, non-randomized	PC, multicenter, non-randomized	PC, monocenter, non-randomized	PC, multicenter, non-randomized	PC, monocenter, non-randomized	PC, multicenter, non-randomized	PC, multicenter, randomized	PC, multicenter, randomized
Countries (centers)	2 (3)	6 (6)	2 (3)	1 (2)	7 (15)	101 (16)	1 (1)	8 (45)	1 (1)	3 (7)	19 (49)	3 (14)
Included patients	131	206	51	238	1768	313	82	598	109	228 (iFR^® = 66)	2492 (iFR^® = 1242)	2037 (iFR^® = 1019
Stenoses	157	206	51	238	1974	392	123	690	151	299 (iFR^® = 85)	3183 (iFR^® = 1575)	3004 (iFR^® = 1568)
Hemodynamic relevant stenoses (%)	N/A	134 (65)	N/A	103 (43.3)	N/A	153 (39)	37 (30.1)	248 (35.9)	N/A	N/A	451 (28.6)	457 (29.1)
Age in years ± SD	62.6 ± 10.2	65.2 ± 10.2	66.2 ± 9.2	62.8 ± 0.6	63.4 ± 10.3	67 ± 11	64 ± 9	63.6 ± 10.8	67 ± 11	58 ± 11	65.5 ± 10.8	67.6 ± 9.6
Men (%)	83.5	71	82.4	68	74.9	79	81.7	68.9	63.9	68	77.5	74.2
Diabetes mellitus (%)	54 (34.4)	50 (24)	14 (27.4)	66 (28)	497 (28.1)	94 (30)	14 (17.1)	209 (35)	N/A	10 (15)	382 (30.8)	232 (22.8)
Hypertonia (%)	88 (56.1)	137 (67)	18 (35.2)	133 (56)	N/A	232 (74)	61 (74.4)	471 (78.8)	N/A	25 (38)	873 (70.3)	730 (71.6)
Smoking (%)	34 (21.7)	64 (31)	15 (29.4)	64 (27)	520 (29.4)	160 (51)	49 (59.8)	135 (22.6)	N/A	21 (32)	243 (19.6)	159 (15.6)
One-vessel CAD (%)	108 (68.8)	85 (41)	N/A	N/A	N/A	113 (36)	50 (61)	N/A	75 (69.4)	N/A	N/A	452 (44.3)
Multi-vessel CAD (%)	49 (31.2)	105 (51)	N/A	N/A	951 (53.8)	197 (63)	32 (39)	N/A	33 (30.6)	N/A	505 (40.7)	364 (35.7)
Stable angina (%)	151 (96.2)	140 (68)	N/A	151 (63)	1216 (68.6)	228 (73)	29 (35)	320 (53.5)	N/A	N/A	986 (79.4)	632 (62.0)
Unstable angina (%)	6 (3.8)	46 (22)	N/A	84 (36)	255 (14.4)	85 (27)	53 (65)	151 (25.3)	N/A	N/A	186 (15.0)	211 (20.7)
iFR^® cut-off	0.83	≤ 0.83	0.86	0.9	0.9	0.9	0.92	0.89	0.896	0.9	0.89	0.89
MACE-rate after 1 yr (iFR^®vs FFR, P-value)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	6.8 vs 7.0 (P = 0.003)	6.7 vs 6.1 (P = 0.007)
Adverse events (iFR^®vs FFR, P-value)	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	3.1 vs 30.8 (P < 0.001)	3.0 vs 68.3 (P < 0.0001)
Diagnostic accuracy in % (iFR^®vs FFR)	93	68	92.3	82	80.4	80	81.3	82.5	83.4	N/A	N/A	N/A

PC: Prospective cohort study; RS: Retrospective study; FFR: Fractional flow reserve; N/A: Not available; MACE: Major adverse cardiac events.

Citation: Baumann S, Chandra L, Skarga E, Renker M, Borggrefe M, Akin I, Lossnitzer D. Instantaneous wave-free ratio (iFR^®) to determine hemodynamically significant coronary stenosis: A comprehensive review. World J Cardiol 2018; 10(12): 267-277
URL: https://www.wjgnet.com/1949-8462/full/v10/i12/267.htm
DOI: https://dx.doi.org/10.4330/wjc.v10.i12.267