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ADVISE trial - Summary & Results

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http://www.theheart.org/web_slides/1337567.do

A study on Vasodilator Free Measure of Fractional Flow Reserve (ADVISE) that investigate a new guidewire-based technology that analyzes pressure inside the vessel without the use of vasodilator agents such as adenosine.

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ADVISE trial - Summary & Results

  1. 1. ADVISE (Vasodilator Free Measure ofFractional Flow Reserve)
  2. 2. ADVISE (Vasodilator Free Measure ofFractional Flow Reserve)J Davies (Imperial College London, UK)TCT 2011• Background: Narrowing of coronary arteries interferes with blood flow and can cause chest pain Cardiologists sometimes quantify the extent of the narrowing by measuring the fractional flow reserve (FFR)—the ratio of the pressure in the aorta to the pressure downstream of the narrowing under conditions of maximal flow• This study investigated a new guidewire-based technology that analyzes pressure inside the vessel without the use of vasodilator agents such as adenosine This would simplify assessment and improve cardiologists’ ability to advise patients on whether or not stent treatment would help their symptoms
  3. 3. ADVISE: Results• The stability and magnitude of resistance measured during the resting wave-free period is similar to the mean resistance achieved during adenosine hyperemia• Intracoronary pressure was measured in 157 patients using iFR and FFR to determine whether the two measurements were equivalent: Analysis showed that iFR and FFR had a strong positive linear correlation (r=0.90) After adjustment for the variability in FFR, the iFR had a diagnostic accuracy of 95%, positive predictive value of 97%, negative predictive value of 93%, and sensitivity and specificity of 93% and 97%, respectivelyiFR=instantaneous wave-free ratio
  4. 4. ADVISE: Commentary*"Its exactly the same as FFR, theres no change, except weve managed tostabilize our resistance using a mathematical algorithm rather than having to give adrug to do the same thing . . . We know now from clinical trials that we do a lotbetter if we dont make our judgments based on visual estimations of stenosis butactually make an assessment based on the pressure drop across the whole lengthof the artery." - Dr Justin Davies*All comments from ADVISE: New pressure measurement does not require adenosine, equals FFR(http://www.theheart.org/article/1308707.do)
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