Evaluation of iFR vs FFR in Stable Angina or Acute Coronary Syndrome

NCT ID: NCT02166736

Last Updated: 2017-01-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

2037 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-31

Study Completion Date

2016-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Previous trials have demonstrated that the use of physiological assessment of stenosis severity using fractional flow reserve (FFR) is superior to angiographic assessment in percutaneous coronary intervention (PCI) and improves clinical outcome. Despite the clinical utility, FFR is used only in 10-15% of patients today. The main reasons for the low adoption rate of FFR are the prolonged procedural time, Adenosine related discomfort and cost associated with Adenosine.

Instantaneous Wave-Free ratio (iFR®) is a novel method to assess coronary lesions for functional significance. The main benefits of the method compared to FFR are that the measurement is instantaneous and does not require Adenosine infusion. Thus, the patient does not experience any discomfort from the measurement and procedural time could be shortened compared to when using FFR. This could potentially increase the adoption rate of physiologic assessment of coronary lesions.

The aim of this trial is to compare the clinical outcome of patients assessed by iFR® with patients assessed by FFR.

Furthermore, the trial will be conducted as a registry based randomized clinical trial (RRCT) which is a novel strategy to conduct clinical trials. The randomization will occur online in the Swedish angiography and angioplasty registry (SWEDEHEART) using a web based platform.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Angina Pectoris Acute Myocardial Infarction

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Instantaneous wave-free ratio (iFR)

Group Type EXPERIMENTAL

iFR

Intervention Type DEVICE

Treatment guided by Instantaneous wave-free ratio (iFR®)

Fractional Flow Reserve (FFR)

Group Type ACTIVE_COMPARATOR

FFR

Intervention Type DEVICE

Intervention guided by Fractional Flow Reserve

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

iFR

Treatment guided by Instantaneous wave-free ratio (iFR®)

Intervention Type DEVICE

FFR

Intervention guided by Fractional Flow Reserve

Intervention Type DEVICE

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients with suspected stable angina pectoris or unstable angina pectoris/non-ST-segment elevation myocardial infarction (NSTEMI) who are scheduled to undergo coronary angiography, and who has an indication for physiology guided assessment of coronary lesions (usually 30-80% stenosis grade). In patients with suspected stable angina pectoris, any lesion may be assessed. In patients with unstable angina pectoris/NSTEMI, only the non-culprit lesion may be assessed.

Exclusion Criteria

* Inability to provide informed consent
* Age below 18 years
* Previous randomization in the iFR-SWEDEHEART trial
* Known terminal disease with a life expectancy of less than one year.
* In patients with multi-vessel disease and other indication than stable angina pectoris, difficulty in assessing which the culprit lesion is.
* Patient with unstable hemodynamics (Killip class III-IV)
* Inability to tolerate Adenosine
* Previous Coronary artery bypass graft (CABG) with patent grafts to the interrogated vessel.
* Heavily calcified or tortuous vessel where inability to cross the lesion with a pressure wire is expected.
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Uppsala University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Matthias Götberg, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiology, Skane University Hospital, Lund University, Lund, Sweden

Ole Fröbert, Prof

Role: STUDY_CHAIR

Department of Cardiology, Örebro University Hospital, Örebro, Sweden

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Skejby University Hospital

Aarhus, , Denmark

Site Status

Reykjavik University Hospital

Reykjavik, , Iceland

Site Status

Sahlgrenska University Hospital

Gothenburg, , Sweden

Site Status

Halmstad sjukhus

Halmstad, , Sweden

Site Status

Helsingborg County Hospital

Helsingborg, , Sweden

Site Status

Kalmar County Hospital

Kalmar, , Sweden

Site Status

Karlstad County Hospital

Karlstad, , Sweden

Site Status

Linköping University Hospital

Linköping, , Sweden

Site Status

Skane University Hospital

Lund, , Sweden

Site Status

Örebro University Hospital

Örebro, , Sweden

Site Status

S:t Göran County Hospital

Stockholm, , Sweden

Site Status

Sundsvall County Hospital

Sundsvall, , Sweden

Site Status

Uppsala University Hospital

Uppsala, , Sweden

Site Status

Västerås County Hospital

Västerås, , Sweden

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Denmark Iceland Sweden

References

Explore related publications, articles, or registry entries linked to this study.

Eftekhari A, Holck EN, Westra J, Olsen NT, Bruun NH, Jensen LO, Engstrom T, Christiansen EH. Instantaneous wave free ratio vs. fractional flow reserve and 5-year mortality: iFR SWEDEHEART and DEFINE FLAIR. Eur Heart J. 2023 Nov 1;44(41):4376-4384. doi: 10.1093/eurheartj/ehad582.

Reference Type DERIVED
PMID: 37634144 (View on PubMed)

Berntorp K, Rylance R, Yndigegn T, Koul S, Frobert O, Christiansen EH, Erlinge D, Gotberg M. Clinical Outcome of Revascularization Deferral With Instantaneous Wave-Free Ratio and Fractional Flow Reserve: A 5-Year Follow-Up Substudy From the iFR-SWEDEHEART Trial. J Am Heart Assoc. 2023 Feb 7;12(3):e028423. doi: 10.1161/JAHA.122.028423. Epub 2023 Feb 3.

Reference Type DERIVED
PMID: 36734349 (View on PubMed)

Gotberg M, Berntorp K, Rylance R, Christiansen EH, Yndigegn T, Gudmundsdottir IJ, Koul S, Sandhall L, Danielewicz M, Jakobsen L, Olsson SE, Olsson H, Omerovic E, Calais F, Lindroos P, Maeng M, Venetsanos D, James SK, Karegren A, Carlsson J, Jensen J, Karlsson AC, Erlinge D, Frobert O. 5-Year Outcomes of PCI Guided by Measurement of Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve. J Am Coll Cardiol. 2022 Mar 15;79(10):965-974. doi: 10.1016/j.jacc.2021.12.030.

Reference Type DERIVED
PMID: 35272801 (View on PubMed)

Gotberg M, Christiansen EH, Gudmundsdottir IJ, Sandhall L, Danielewicz M, Jakobsen L, Olsson SE, Ohagen P, Olsson H, Omerovic E, Calais F, Lindroos P, Maeng M, Todt T, Venetsanos D, James SK, Karegren A, Nilsson M, Carlsson J, Hauer D, Jensen J, Karlsson AC, Panayi G, Erlinge D, Frobert O; iFR-SWEDEHEART Investigators. Instantaneous Wave-free Ratio versus Fractional Flow Reserve to Guide PCI. N Engl J Med. 2017 May 11;376(19):1813-1823. doi: 10.1056/NEJMoa1616540. Epub 2017 Mar 18.

Reference Type DERIVED
PMID: 28317438 (View on PubMed)

Gotberg M, Christiansen EH, Gudmundsdottir I, Sandhall L, Omerovic E, James SK, Erlinge D, Frobert O. Instantaneous Wave-Free Ratio versus Fractional Flow Reserve guided intervention (iFR-SWEDEHEART): Rationale and design of a multicenter, prospective, registry-based randomized clinical trial. Am Heart J. 2015 Nov;170(5):945-50. doi: 10.1016/j.ahj.2015.07.031. Epub 2015 Aug 15.

Reference Type DERIVED
PMID: 26542503 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

U-2013-044

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.