Invasive Coronary Physiology Assessment for Patients with Stable Coronary Disease

Islam Y. Elgendy, Ali Denktas, Nils P. Johnson, Farouc A. Jaffer, Hani Jneid

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations

Abstract

Visual assessment of coronary stenosis severity using conventional coronary angiography is associated with wide interoperator variability and a weak relationship with hemodynamics. Invasive coronary physiology assessment using fractional flow reserve (FFR) has been shown to be safe and beneficial. Large multicenter randomized trials have demonstrated the superiority of FFR-guided percutaneous coronary intervention in reducing the risk of major cardiac adverse events, number of stents used, and total cost in patients with multivessel coronary disease. FFR requires vasodilatory agents for the microvasculature to induce maximal hyperemia, which carry a slight risk, cost, and effort. Nonhyperemic pressure ratios provide a physiologic metric without vasodilator medications but with more limited clinical outcomes data. The transition from anatomy to physiology for coronary artery disease decision-making represents a cultural sea change in the cardiac catheterization laboratory that requires time and retooling.

Original languageEnglish (US)
Pages (from-to)263-266
Number of pages4
JournalCardiology in Review
Volume30
Issue number5
DOIs
StatePublished - Sep 1 2022

Keywords

  • coronary artery disease
  • fractional flow reserve
  • major adverse cardiac events
  • nonhyperemic pressure ratios
  • revascularization

ASJC Scopus subject areas

  • Medicine(all)

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