Physiology Data Drives Successful, State-of-the-Art PCI

No two CAD patients are the same. SYNTAX II -- which now shows that more PCI patients can experience CABG-like outcomes out to five years -- emphasizes comprehensive physiology assessment before and after intervention. This functional patient information can impact treatment decisions and preparation, as well as provide clinical value post-procedure.

Optimized Interventions are Informed by Functional Data at Every Step

FFR assessment and guidance during procedure planning reduces MACCE*

The SYNTAX II trial¹ PCI algorithm mandated fractional flow reserve (FFR) measurement and IFR for lesion evaluation in every patient and related results included:

Physiologic assessment occurred in 98% of patients.
1.4 less lesions per patient treated.
Changed three-vessel disease diagnoses in nearly 2/3 of patients.
46% reduction of the three-vessel ischemic disease diagnosis compared to when no physiology was used.

The FAME I & II² trials provide evidence that incorporating FFR guidance into PCI procedure planning reduces the rate of major adverse cardiac events.

FFR-guided stenting reduced rate of composite endpoint of death, nonfatal myocardial infarction, and repeat revascularization (13.2% vs 18.3%).
Patients with ischemic lesions treated by PCI and MT, versus MT alone, had significantly lower rates of death, MI, and urgent revascularization.

Post-Procedure Physiology Assessment is an Indicator of Long-Term Outcomes

The DEFINE trial³ highlights the importance of physiology assessment after PCI. It demonstrates that patients whose baseline ischemia was more effectively treated had significantly improved outcomes and less recurrent angina at one-year post-procedure. Ischemia was measured immediately after intervention via instantaneous wave-free ratio (iFR).

Patients >=0.95 had a statistically significant reduction of cardiac death, spontaneous MI, or clinically driven TVR compared to post-PCI iFR of <0.95.

What do I need to know about Physiology?

Listen to this 60-minute session on EDUCARE featuring Ziad Ali, M.D. and Ajay Kirtane, M.D.

Measure FFR, DFR™ & Pd/Pa in Coronary Physiology

You have options in coronary physiology.

Pd/Pa calculates the entire cardiac cycle at rest.
FFR calculates Pd/Pa during maximal hyperemia
DFR™ calculates a diastolic portion of the cardiac cycle at rest.

	FFR	DFR	Pd/Pa
Type	Whole-cycle	Diastolic	Whole-cycle
Cutoff	0.80	0.89	0.91
No Hyperemic Agent Required	X	✔	✔
Inclusion in Appropriate Use Criteria^*	✔	✔	✔
Workhorse Pressure Guidewire Available	✔	✔	✔

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