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Peer Review

Peer Reviewed

Original Contribution

Percutaneous Coronary Intervention vs Medical Therapy for Coronary Lesions With Positive Fractional Flow Reserve (FFR) but Preserved Pressure-Bounded Coronary Flow Reserve (CFR): A Substudy of the Randomized Compare-Acute Trial

Joost D.E. Haeck, MD, PhD1;  Marcel van’t Veer, PhD2; 
Frederik M. Zimmermann, MD2;  Franz-Josef Neumann, MD3; 
Andreas S. Triantafyllis, MD, PhD4;  Krischan D. Sjauw, MD, PhD1;
Mohamed Abdel-Wahab, MD5;  Elmir Omerovic, MD6; 
Bianca M. Boxma-de Klerk, PhD7;  Nico H.J. Pijls, MD, PhD2;
Gert Richardt, MD, PhD8;  Pim A.L. Tonino, MD, PhD2; 
Nils P. Johnson, MD, MS9;  Pieter C. Smits, MD, PhD7 

Keywords
July 2021
1557-2501
J INVASIVE CARDIOL 2021;33(7):E557-E564. Epub 2021 June 5. doi:10.25270/jic/20.00578
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1. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J. 2019;40:87-165. 

2. Knuuti J, Wijns W, Saraste A, et al. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J. 2019;41:407-477.

3. Smits PC, Abdel-Wahab M, Neumann F-J, et al. Fractional flow reserve–guided multivessel angioplasty in myocardial infarction. N Engl J Med. 2017;376:1234-1244. 

4. Zimmermann FM, Omerovic E, Fournier S, et al. Fractional flow reserve-guided percutaneous coronary intervention vs medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data. Eur Heart J. 2019;40:180-186.

5. Xaplanteris P, Fournier S, Pijls NHJ, et al. Five-year outcomes with PCI guided by fractional flow reserve. N Engl J Med. 2018;379:250-259.

6. Engstrøm T, Kelbæk H, Helqvist S, et al. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3-PRIMULTI): an open-label, randomised controlled trial. Lancet. 2015;386:665-671. 

7. Ahn JM, Zimmermann FM, Johnson NP, et al. Fractional flow reserve and pressure-bounded coronary flow reserve to predict outcomes in coronary artery disease. Eur Heart J. 2017;38:1980-1989.

8. Van De Hoef TP, Siebes M, Spaan JAE, Piek JJ. Fundamentals in clinical coronary physiology: why coronary flow is more important than coronary pressure. Eur Heart J. 2015;36:3312-3319. 

9. Zimmermann FM, Pijls NHJ, De Bruyne B, et al. What can intracoronary pressure measurements tell us about flow reserve? Pressure-bounded coronary flow reserve and example application to the randomized DEFER trial. Catheter Cardiovasc Interv. 2017;90:917-925. 

10. Smits PC, Assaf A, Richardt G, Omerovic E, Abdel-Wahab M, Neumann FJ. Design and rationale of the COMPARE-ACUTE trial: fractional flow reserve–guided primary multivessel percutaneous coronary intervention to improve guideline indexed actual standard of care for treatment of ST-elevation myocardial infarction in patients with multivessel coronary disease. Am Heart J. 2017;186:21-28. Epub 2017 Jan 5.

11. Wijntjens GWM, van Lavieren MA, van de Hoef TP, et al. Pressure-derived estimations of coronary flow reserve are inferior to flow-derived coronary flow reserve as diagnostic and risk stratification tools. Int J Cardiol. 2019;279:6-11.

12. Lee JM, Jung JH, Hwang D, et al. Coronary flow reserve and microcirculatory resistance in patients with intermediate coronary stenosis. J Am Coll Cardiol. 2016;67:1158-1169.

13. Lee JM, Choi KH, Koo BK, et al. Prognostic implications of plaque characteristics and stenosis severity in patients with coronary artery disease. J Am Coll Cardiol. 2019;73:2413-2424.

14. Driessen RS, de Waard GA, Stuijfzand WJ, et al. Adverse plaque characteristics relate more strongly with hyperemic fractional flow reserve and instantaneous wave-free ratio than with resting instantaneous wave-free ratio. JACC Cardiovasc Imaging. 2020;13:746-756.


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