Читать книгу Interventional Cardiology - Группа авторов - Страница 190

IFR has been compared to FFR in a number of studies, notably the ADVISE family of studies [63–66]. The degree of classification match is strongly dependent upon the distribution of lesions included with clinical cohorts demonstrating 80–88% match. The limit of match is driven by the capacity for FFR to match itself when repeated; this natural variability is highest close to the threshold with nearly 15% of cases showing a change in classification on repeat measurement [67]. When compared to third party markers of ischemia, including HSR, CFR, SPECT, and PET imaging, iFR and FFR are equal in their capacity to detect ischemia [68–72].

Clinical outcome studies have compared the use of iFR and FFR to determine revascularization decisions for moderate stenoses. Two large randomized controlled trials: DEFINE‐FLAIR (blinded) and the iFR‐Swedeheart (open‐label) have demonstrated equivalent event rates for both iFR and FFR at one and two years [18,73]. The two studies had design co‐alignment allowing combination of the datasets with additional power; combined analysis confirms the overall findings and provides reassurance that managing patients with either index is safe and efficient approach.