Key result
FFR correlates more strongly with coronary plaque burden than resting Pd/Pa or iFR/RFR.
Why the study?
The relationship between FFR, RFR, iFR, Pd/Pa, and coronary plaque burden as well as phenotype required further elucidation.
Does hyperemic FFR correlate stronger with coronary plaque burden and adverse plaque phenotype than nonhyperemic pressure indexes (Pd/Pa, iFR, RFR) in patients with suspected coronary artery disease?
Cohort (n=241)
Single-blind
No
Does hyperemic FFR correlate stronger with coronary plaque burden and adverse plaque phenotype than nonhyperemic pressure indexes (Pd/Pa, iFR, RFR) in patients with suspected coronary artery disease?
Fractional flow reserve (FFR) provides a stronger correlation with overall coronary plaque burden and adverse plaque phenotypes (like low-attenuation plaque) than resting nonhyperemic pressure indexes.
FFR may better reflect plaque burden than resting indices; leaves open whether this refines risk stratification or therapy in CAD.
BACKGROUND: The relationship between fractional flow reserve (FFR), resting full-cycle ratio (RFR), instantaneous wave-free ratio (iFR), resting distal pressure/aortic pressure (Pd/Pa), and plaque burden as well as phenotype requires further elucidation. METHODS AND RESULTS: In this single-center cohort study, patients with suspected coronary artery disease who underwent invasive coronary angiography, including routine hyperemic (FFR) and nonhyperemic invasive pressure (Pd/Pa and iFR or RFR) interrogation and computed coronary tomography angiography were prospectively enrolled. Computed coronary tomography angiography was used to assess percentage atheroma volume (PAV), positive remodeling, and low-attenuation plaque. =0.10, respectively). None of the invasive pressure measurements was independently associated with positive remodeling. Pressure index discordancy was not associated with positive remodeling or low-attenuation plaque. CONCLUSIONS: FFR correlated stronger to plaque burden, as defined by PAV, than nonhyperemic pressure indexes. For plaque phenotype, both FFR and iFR/RFR were independently associated with low-attenuation plaque, whereas none of the invasive pressure indexes was associated with positive remodeling.
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Jukema et al. (2025) conducted a cohort in Suspected coronary artery disease (n=241). Fractional flow reserve (FFR) vs. Nonhyperemic pressure indexes (Pd/Pa and iFR/RFR) was evaluated on Correlation with percentage atheroma volume (PAV) (r=-0.56, 95% CI -0.62 to -0.50, p=<0.01). Fractional flow reserve correlated stronger to coronary plaque burden (percentage atheroma volume) than resting distal pressure/aortic pressure (r=-0.56 vs r=-0.43; P<0.01) and iFR/RFR (r=-0.47; P=0.04).
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