This tool assesses clogged arteries while reducing discomfort

For patients experiencing angina (chest pain) or a heart attack, a new tool called instantaneous wave-free ratio (iFR) was equivalent to the currently-preferred tool, fractional flow reserve (FFR), according to recent research.

The studies also showed iFR resulted in markedly less patient discomfort and reduced procedure-related adverse events compared to FFR.

Despite being a recommended diagnostic tool for assessing the condition of the coronary arteries, FFR has been underutilized in practice, in part because it causes discomfort, chest pain and shortness of breath for many patients, researchers said.

The study results suggest that iFR, which has emerged as a potential alternative to FFR, could offer the same benefits as FFR while avoiding its downsides.

The studies showed no significant difference between iFR and FFR for the primary endpoint, which was in both trials a composite of all-cause mortality, non-fatal heart attack and unplanned revascularization (procedures used to unblock clogged arteries, such as angioplasty and bypass surgery), at 12 months.

Both FFR and iFR are based on coronary physiology, a direct, internal measure of blood pressure within the arteries.

“Our study shows that it is safe to use either the iFR or FFR technique,” said Justin E. Davies, MBBS, PhD, the lead author.

“I think iFR lowers the barriers to physiological measurement, which I believe is key to getting more people to use coronary physiology to guide coronary revascularization decision-making. iFR technology really enables ease of use; it’s very friendly for the physician and patients alike.”

Cardiologists encounter patients with narrowing of the coronary arteries on a daily basis. They typically use angiography, a form of X-ray, as an initial tool to visually estimate the severity of narrowing, but it is difficult to accurately assess, based on a visual estimation alone, whether a stent is needed to widen the artery and allow the blood…

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