Adequacy of intracoronary versus intravenous adenosine-induced maximal coronary hyperemia for fractional flow reserve measurements
Key result
Intracoronary adenosine highly correlates with IV FFR despite suboptimal hyperemia in ~8% of lesions.
- Mean difference -0.004
- P<.001
- n=52
Why the study?
Does intracoronary adenosine provide equivalent fractional flow reserve measurements compared to intravenous adenosine in patients with coronary lesions?
Population
52 patients with 60 coronary lesions undergoing fractional flow reserve (FFR) measurement
Comparison
Intracoronary adenosine boluses vs Intravenous adenosine continuous infusion at a…
Design
Cross-sectional
Authors
Discussion
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Implication
Intracoronary adenosine may suffice for most FFR assessments with fewer side effects; leaves open equivalence in all lesions pending prospective validation.
Structured PICO
Does intracoronary adenosine provide equivalent fractional flow reserve measurements compared to intravenous adenosine in patients with coronary lesions?
P
Population
52 patients with 60 coronary lesions undergoing fractional flow reserve measurement with both intravenous and intracoronary adenosine.
I
Intervention
Intracoronary (IC) adenosine boluses (15 to 20 microgram in the right and 18 to 24 microgram in the left coronary artery)
C
Comparator
Intravenous (IV) adenosine continuous infusion at a rate of 140 microgram/kg per minute
O
Outcome
Fractional flow reserve (FFR) measurement correlation and agreement between IC and IV adenosinesurrogate
Main Result
Mean Difference: -0.004
p-value: p=<.001
Intracoronary adenosine is equivalent to intravenous infusion for FFR determination in most patients and has fewer side effects, though it may yield suboptimal hyperemia in a small percentage of cases.
Cite This Study
Jeremias et al. (2000) studied Coronary stenosis (n=52). Intracoronary (IC) adenosine vs. Intravenous (IV) adenosine was evaluated on Fractional flow reserve (FFR) measurement agreement (Mean difference -0.004, p=<.001). Intracoronary adenosine yielded FFR measurements highly correlated with intravenous infusion (R=0.978, P<0.001), though 8.3% of lesions had a suboptimal hyperemic response with the intracoronary route.