Clinical outcomes of physiologically-guided revascularisation

Nasir Rahman, Ghufran Adnan, Awais Farhad, Jamshed Ali, Ihsan Ullah

Research output: Contribution to journalArticlepeer-review


Objective: To assess the clinical outcomes of revascularisation based on fractional flow reserve (FFR) and/or instantaneous wave-free ratio (iFR). Study Design: Descriptive study. Place and Duration of Study: Department of Medicine, The Aga Khan University Hospital, Karachi from January 2012 to January 2020. Methodology: A cohort of patients having moderate to severe coronary stenosis, undergoing coronary revascularisation based on invasive physiological assessment (FFR or iFR) were assessed. The participants were divided into the revascularisation-deferred group and the revascularization-performed group, based on the physiological results. Cox-proportional hazard model building was done, using a stepwise approach by assessing all plausible interactions and considering p-value ≤0.05 as statistically significant. Results: The frequency of major adverse cardiac event (MACE) and target vessel revascularisation was 8.4% and 3.2% in the revascularisation-performed group as compared to 6.4% and 3.2% in the revascularisation-deferred group. In adjusted models, no statistically significant difference was noted in MACE when comparing the revascularisation-performed group with a deferred group. Conclusion: Revascularisation guided by invasive physiological assessment with FFR or iFR is clinically safe and led to better resource utilisation.

Original languageEnglish
Pages (from-to)1263-1267
Number of pages5
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Issue number11
Publication statusPublished - Nov 2021


  • Fractional flow reserve
  • Instantaneous wave-free ratio
  • Invasive physiological assessment
  • Low-middle income country


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