Abstract

Stable coronary artery disease (CAD) presents with intermediate lesions that complicate treatment decisions. Visual assessment of coronary angiography may not accurately reflect the hemodynamic significance of these lesions. Instantaneous Wave-Free Ratio (IFR) is a new physiological index providing objective information on lesion functional significance. This study aimed to detect magnitude and direction of reclassification of intermediate lesions treatment after hemodynamic assessment by IFR in patients with stable CAD. Methods: This prospective observational study was carried out on 50 patients with stable coronary artery disease admitted to a single center. Patient received coronary angiography for a consultant's visual evaluation in order to identify the first treatment protocol. Hemodynamic assessment using IFR was performed for intermediate lesions to reclassify the treatment strategy. Results: The mean age of the patients was 64.2 ± 12.11 years, with 76% males and 24% females. The majority of patients had hypertension (74%), followed by diabetes mellitus (46%), hyperlipidemia (64%), smoking history (62%), and chronic kidney disease (22%). Based on the IFR assessment, 80% of patients were reclassified to receive medical treatment, while 20% underwent PCI. Conclusion: Our study results show that IFR is a reliable and accurate tool for guiding revascularization decisions in CAD patients. The majority of patients in our study, 80%, were safely reclassified to medical treatment based on IFR results. In the remaining 20% of patients, IFR results showed significant lesions that required PCI

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