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. 2025 Jun 15:245:81-86.
doi: 10.1016/j.amjcard.2025.02.029. Epub 2025 Mar 13.

Discordant Diagnostics: A Case Series of iFR and FFR Discrepancies

Ahmed Kazem  1 , Magdi Zordok  2 , Will Hobbs  3 , Mohamed Salih  1 , Amr Marawan  1 , Dinesh Apala  4 , Sibi Thomas  1 , Robert J Widmer  5 , Salman Allana  6 , Srinivasa Potluri  1 , Karim Al-Azizi  7
Affiliations

Discordant Diagnostics: A Case Series of iFR and FFR Discrepancies

Ahmed Kazem et al. Am J Cardiol. .

Abstract

Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) are 2 methods used to detect hemodynamically significant lesions and guide revascularization. Discrepancies between FFR and iFR values can complicate revascularization decisions. We present a series of 6 cases with discrepant FFR and iFR results. Among them, 5 were men, 5 had lesions in the right coronary artery, and one had left anterior descending disease, with an average age of 61.7 ± 11.1 years. All patients were iFR negative (mean iFR 0.94 ± 0.02) and FFR positive (mean FFR 0.75 ± 0.04). Consequently, all patients underwent revascularization.

Keywords: coronary angiography; coronary interventions; fractional flow reserve; instantaneous wave-free ratio; intravascular diagnostics.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Karim Al-Azizi reports a relationship with Abbott Vascular Inc that includes: consulting or advisory and speaking and lecture fees. Karim Al-Azizi reports a relationship with Boston Scientific Corporation that includes: consulting or advisory and speaking and lecture fees. Karim Al-Azizi reports a relationship with Medtronic that includes: consulting or advisory and speaking and lecture fees. Karim Al-Azizi reports a relationship with Edwards Lifesciences Corporation that includes: consulting or advisory and speaking and lecture fees. Karim Al-Azizi reports a relationship with Cordis Corporation that includes: consulting or advisory and speaking and lecture fees. Karim Al-Azizi reports a relationship with Philips Healthcare that includes: consulting or advisory and speaking and lecture fees. Sibi Thomas reports a relationship with Philips Healthcare that includes: consulting or advisory and speaking and lecture fees. Sibi Thomas reports a relationship with Boston Scientific Corporation that includes: consulting or advisory and speaking and lecture fees. Salman Allana reports a relationship with Boston Scientific Corporation that includes: consulting or advisory and speaking and lecture fees. Robert J Widmer reports a relationship with Abbott Vascular Inc that includes: consulting or advisory and speaking and lecture fees. Robert J Widmer reports a relationship with Medtronic Inc that includes: consulting or advisory and speaking and lecture fees. Robert J Widmer reports a relationship with Philips Healthcare that includes: consulting or advisory and speaking and lecture fees. Srinivasa Potluri reports a relationship with Philips Healthcare that includes: consulting or advisory and speaking and lecture fees. Srinivasa Potluri reports a relationship with Abbott Vascular Inc that includes: consulting or advisory and speaking and lecture fees. Srinivasa Potluri reports a relationship with Boston Scientific Corporation that includes: consulting or advisory and speaking and lecture fees. Srinivasa Potluri reports a relationship with Edwards Lifesciences Corporation that includes: consulting or advisory and speaking and lecture fees. Srinivasa Potluri reports a relationship with Medtronic Inc that includes: consulting or advisory and speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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