The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments

Mikołaj Błaziak; Szymon Urban; Weronika Wietrzyk; Maksym Jura; Izabella Świerczek; Wiktor Kuliczkowski

doi:10.5114/aic.2025.151856

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Original paper

The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments

Mikołaj Błaziak

^{1, 2}

,

Szymon Urban

³

,

Weronika Wietrzyk

²

,

Maksym Jura

^{2, 4}

,

Izabella Świerczek

⁵

,

Wiktor Kuliczkowski

^{1, 2}

Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
University Hospital in Wroclaw, Wroclaw, Poland
Department of Cardiology, The Copper Health Centre (MCZ), Lubin, Poland
Wroclaw Medical University, Faculty of Medicine, Institute for Heart Diseases, Wroclaw, Poland
J. Korczak Provincial Specialist Hospital, Slupsk, Poland

Adv Interv Cardiol 2025; 21, 2 (80): 178–184

DOI: https://doi.org/10.5114/aic.2025.151856

Online publish date: 2025/06/05

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AMA

Błaziak M, Urban S, Wietrzyk W, Jura M, Świerczek I, Kuliczkowski W. The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2025;21(2):178-184. doi:10.5114/aic.2025.151856.

APA

Błaziak, M., Urban, S., Wietrzyk, W., Jura, M., Świerczek, I.,  & Kuliczkowski, W. (2025). The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 21(2), 178-184. https://doi.org/10.5114/aic.2025.151856

Chicago

Błaziak, Mikołaj, Szymon Urban, Weronika Wietrzyk, Maksym Jura, Izabella Świerczek,  and Wiktor Kuliczkowski. 2025. "The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 21 (2): 178-184. doi:10.5114/aic.2025.151856.

Harvard

Błaziak, M., Urban, S., Wietrzyk, W., Jura, M., Świerczek, I.,  and Kuliczkowski, W. (2025). The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 21(2), pp.178-184. https://doi.org/10.5114/aic.2025.151856

MLA

Błaziak, Mikołaj et al. "The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 21, no. 2, 2025, pp. 178-184. doi:10.5114/aic.2025.151856.

Vancouver

Błaziak M, Urban S, Wietrzyk W, Jura M, Świerczek I, Kuliczkowski W. The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2025;21(2):178-184. doi:10.5114/aic.2025.151856.

Introduction:
Fractional flow reserve (FFR) remains the gold standard for functional evaluation in coronary artery disease (CAD). However, non-hyperemic indices, such as diastolic pressure ratio (dPR) and resting full-cycle ratio (RFR), are increasingly utilized in clinical practice. Data on the safety and long-term outcomes of deferred revascularization based on these indices remain limited.

Aim:
This study aimed to evaluate the safety of deferred revascularization in patients with CAD using dPR and RFR indices.

Material and methods:
Between January and June 2022, all consecutive patients undergoing functional coronary evaluations at a large tertiary hospital were screened. Primary endpoints included major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction (MI), and target vessel revascularization (TVR), along with individual endpoints at 1-year follow-up.

Results:
Of 321 patients evaluated, 290 met the eligibility criteria, and 204 underwent deferred revascularization based on non-hyperemic assessments. The cohort had a mean age of 68.2 years (SD ±8.9), with 76.8% male. Chronic coronary syndrome (57.2%), unstable angina (13.8%), and heart failure (9.3%) were the primary indications for coronary angiography. Among 230 lesions assessed with dPR and 243 with RFR, positive findings were observed in 17.4% and 13.2%, respectively (p = 0.15). At 1-year follow-up, MACE occurred in 7.8%, all-cause mortality was 4.9%, MI was 0.5%, and TVR was 2.5%.

Conclusions:
Deferred revascularization guided by dPR and RFR appears safe, with outcomes comparable to FFR-guided decisions in the literature. Larger randomized trials are needed to confirm these findings.

keywords:

The safety profile of deferred revascularization in patients with coronary artery disease undergoing non-hyperemic functional assessments

Mikołaj Błaziak 1, 2 , Szymon Urban 3 , Weronika Wietrzyk 2 , Maksym Jura 2, 4 , Izabella Świerczek 5 , Wiktor Kuliczkowski 1, 2

coronary artery disease, fractional flow reserve, non-hyperemic indices

Mikołaj Błaziak

^{1, 2}

,

Szymon Urban

³

,

Weronika Wietrzyk

²

,

Maksym Jura

^{2, 4}

,

Izabella Świerczek

⁵

,

Wiktor Kuliczkowski

^{1, 2}