April 1, 2016Open Access

Continuum of Vasodilator Stress From Rest to Contrast Medium to Adenosine Hyperemia for Fractional Flow Reserve Assessment

Key Result

cFFR demonstrated superior performance compared to Pd/Pa or iFR in predicting FFR, achieving approximately 85% agreement with the reference standard.

Structured PICO

Does cFFR provide superior diagnostic performance compared to Pd/Pa or iFR for predicting FFR?

Intervention

Contrast fractional flow reserve (cFFR)

Comparator

Resting Pd/Pa, instantaneous wave-free ratio (iFR), and adenosine fractional flow reserve (FFR) as the reference standard

Outcome

Diagnostic performance for predicting FFR (agreement rate)surrogate

cFFR offers a simplified alternative for invasive coronary physiological assessment when adenosine is contraindicated or prohibitively expensive, though FFR remains the reference standard.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

cFFR provides diagnostic performance superior to that of Pd/Pa or iFR for predicting FFR. For clinical scenarios or health care systems in which adenosine is contraindicated or prohibitively expensive, cFFR offers a universal technique to simplify invasive coronary physiological assessments. Yet FFR remains the reference standard for diagnostic certainty as even cFFR reached only ∼85% agreement.