Key result
iFR shows superior diagnostic accuracy for inducible myocardial ischemia versus other pressure-derived indices.
Why the study?
Does the instantaneous wavefree ratio (iFR) accurately identify inducible myocardial ischemia in patients with left main or left anterior descending coronary artery disease?
Observational (n=227)
Does the instantaneous wavefree ratio (iFR) accurately identify inducible myocardial ischemia in patients with left main or left anterior descending coronary artery disease?
iFR provides superior diagnostic accuracy for identifying inducible myocardial ischemia compared to other indices, and PCI yields the most symptomatic relief in patients with IMI-related chest pain.
May support iFR preference for ischemia detection in LM/LAD disease; leaves open outcome impact in prospective trials.
We evaluated the relationship between pressure-derived physiologic indices and inducible myocardial ischemia (IMI), defined by significant ST-segment changes during adenosine stress testing, in 227 patients with left main or left anterior descending coronary artery disease. Associations with symptomatic improvement, assessed by the 7-item Seattle Angina Questionnaire at 1 month post-PCI, were also analyzed. Optimal cut-off values for IMI were lower than current thresholds, with the instantaneous wavefree ratio (iFR) showing superior diagnostic accuracy (higher AUC) compared to other indices. PCI provided the greatest symptomatic relief in patients with moderate-to-severe angina and concomitant IMI. In conclusion, iFR more accurately identifies IMI, and PCI benefits are most pronounced in patients with IMI-related chest pain.
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Kang et al. (2025) conducted an observational in Left main or left anterior descending coronary artery disease (n=227). Instantaneous wavefree ratio (iFR) and other pressure-derived physiologic indices vs. Other pressure-derived indices was evaluated on Diagnostic accuracy (AUC) for identifying inducible myocardial ischemia (IMI). The instantaneous wavefree ratio (iFR) demonstrated superior diagnostic accuracy (higher AUC) for identifying inducible myocardial ischemia compared to other pressure-derived physiologic indices.
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