Evidence mapPaperPMID 41356313Full record

SynthesisReviews in cardiovascular medicine2025

Clinical Outcomes Following Discordance Between Fractional Flow Reserve and Instantaneous Wave-Free Ratio in Deferred Coronary Lesions: A Systematic Review and Meta-Analysis.

Spyridon Graidis, Filippos Timpilis, Georgia Xygka, Asimenia Katsea, Antonios Karanasos, Grigorios Tsigkas, Athanasios Moulias, Virginia Mplani, Periklis Davlouros, Michail Papafaklis

Abstract readSystematic Review
In one paragraph

Synthesis in Reviews in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Spyridon GraidisCardiology Division, University Hospital of Patras, 26504 Rio, Greece.ORCID https://orcid.org/0000-0003-0356-850X
Filippos TimpilisFaculty of Medicine, University of Patras, 26504 Rio, Greece.
Georgia XygkaCardiology Division, University Hospital of Patras, 26504 Rio, Greece.
Asimenia KatseaCardiology Division, University Hospital of Patras, 26504 Rio, Greece.
Antonios KaranasosCardiology Division, University Hospital of Patras, 26504 Rio, Greece.ORCID https://orcid.org/0000-0001-8052-6739
Grigorios TsigkasCardiology Division, University Hospital of Patras, 26504 Rio, Greece.ORCID https://orcid.org/0000-0002-2779-0765
Athanasios MouliasCardiology Division, University Hospital of Patras, 26504 Rio, Greece.
Virginia MplaniIntensive Care Unit, University Hospital of Patras, 26504 Rio, Greece.
Periklis DavlourosCardiology Division, University Hospital of Patras, 26504 Rio, Greece.ORCID https://orcid.org/0000-0002-1439-1992
Michail PapafaklisCardiology Division, University Hospital of Patras, 26504 Rio, Greece.ORCID https://orcid.org/0000-0002-5646-0378

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Current guidelines recommend the use of either fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) for assessing intermediate coronary stenoses. However, FFR/iFR discordance occurs in approximately 20% of cases. This systematic review and meta-analysis aimed to investigate whether deferring lesions with discordant FFR/iFR classification is associated with worse prognosis compared to those with negative concordant results (FFR-/iFR-). Methods: A systematic search was conducted in literature repositories to identify all studies that compared the clinical prognosis of deferred lesions with discordant and concordant FFR/iFR results. The primary endpoint was a composite clinical outcome of the individual secondary endpoints (death, myocardial infarction, and revascularization). Results: Three eligible observational studies (1735 deferred vessels) were included in the meta-analysis. Overall, deferred lesions with FFR/iFR discordance presented numerically higher event rates for all primary and secondary endpoints compared to deferred lesions with negative concordance; however, none reached statistical significance. Deferred lesions with FFR-/iFR+ discordance were significantly associated with an increased risk of death (odds ratio [OR]: 3.19; Conclusions: Compared to deferred lesions with negative concordant results, deferred lesions with discordant FFR/iFR results were overall not significantly associated with worse clinical outcomes; however, there was a significantly greater risk of death for deferred lesions specifically with FFR-/iFR+ discordance, and an increased risk of revascularization for deferred lesions with FFR+/iFR- discordance. Further dedicated trials are needed to improve guidance in clinical decision-making. The PROSPERO Registration: CRD420251135424, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251135424.

Indexed as

clinical decisioncoronary artery diseasecoronary stenosesfractional flow reserveinstantaneous wave-free ratiomortalitypercutaneous coronary interventionrevascularization

Identifiers

PMID41356313
PMCPMC12680999

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.