• Teruaki Wada, Yasutsugu Shiono, Takashi Kubo, Kentaro Honda, Masahiro Takahata, Kunihiro Shimamura, Mitsuru Yuzaki, Takashi Tanimoto, Yoshiki Matsuo, Atsushi Tanaka, Takeshi Hozumi, Yoshiharu Nishimura, and Takashi Akasaka.
• Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
• Int. J. Cardiol. 2021 Feb 1; 324: 23-29.

BackgroundWe aimed to assess an impact of instantaneous wave-free ratio (iFR) on a graft failure after coronary artery bypass grafting (CABG).Methods And ResultsA total of 131 coronary arteries from 88 patients who underwent invasive coronary angiography, intracoronary pressure measurements, CABG, and scheduled follow-up coronary computed tomography angiography within one year were investigated. All studied arteries had FFR <0.80. The rate of graft failure was significantly higher in vessels with negative iFR (>0.89) than in those with positive iFR (<0.89) (25.7% vs. 7.3%, p = 0.012). The graft failure rates increased as the preoperative iFR values rose (iFR <0.80, 3.3%; iFR: 0.80-0.84, 5.6%; iFR: 0.85-0.89, 16.0%; iFR: 0.90-0.94, 28.0%; and iFR: 0.95-1.00, 50.0%; p = 0.002). A cut-off value of iFR to predict graft failures was determined as 0.84 by receiver-operating characteristic curve analysis with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 88%, 62%, 25%, 97%, and 66%, respectively.ConclusionsThe risk of graft failure becomes higher, as the preoperative iFR increases. The graft failure is significantly more frequent when a bypass graft is anastomosed on vessels with negative iFR than those with positive iFR.Copyright © 2020 Elsevier B.V. All rights reserved.

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