Randomized Comparison of Fractional Flow Reserve and Instantaneous Wave Free Ratio in Serial Disease.

Matthew E Li Kam Wa, Saad M Ezad, Bhavik Modi, Ozan M Demir, Jonathan Hinton, Howard Ellis, Kalpa De Silva, Ankur Gulati, Ranil De Silva, Peter O'Kane, Abdel Douiri, Damien Collison, Nick Curzen, Carlos Collet, Divaka Perera

July 2025 JACC Cardiovasc Interv

Synopsis of Social media discussions

The collective discussions show strong support for the study's findings, with participants emphasizing the need for post-PCI physiology reassessment. The tone varies from professional acclaim, like 'great work' and 'brilliant summary,' to technical analysis of overestimations in hemodynamic benefits, demonstrating both high interest and active engagement in clinical implications.

A
Agreement
 Moderate agreement

Most discussions support the findings that FFR and iFR may overestimate PCI benefits and emphasize the importance of post-PCI physiology assessment.

I
Interest
 High level of interest

Posts demonstrate high interest by highlighting the novelty of the comparison and its implications for clinical practice.

E
Engagement
 Moderate level of engagement

Several discussions delve into specific results, such as overestimation of benefits and residual ischemia, indicating active engagement.

I
Impact
 Moderate level of impact

The discussions suggest the study could influence clinical protocols, emphasizing routine post-PCI assessments, which has a moderate yet meaningful impact.

Social Mentions

YouTube

3 Videos

Twitter

51 Posts

Metrics

Video Views

716

Total Likes

141

Extended Reach

352,242

Social Features

54

Timeline: Posts about article

Top Social Media Posts

Posts referencing the article

Comparing FFR and iFR in Complex Coronary Disease Evaluation

Comparing FFR and iFR in Complex Coronary Disease Evaluation

This study assesses the performance of fractional flow reserve and instantaneous wave-free ratio in serial and diffuse coronary disease, highlighting iFR's superior predictive accuracy for post-PCI outcomes and emphasizing the need for re-evaluation after procedures.

UK Heart Research

July 14, 2025

456 views

Comparison of FFR and iFR in Serial Coronary Disease Diagnosis

Comparison of FFR and iFR in Serial Coronary Disease Diagnosis

Divaka Perera MD and F Aaysha Cader MBBS MD MSc FACC discuss the SERIAL study, the first randomized comparison of FFR and iFR in serial coronary artery disease, highlighting iFR's superior accuracy in predicting post-PCI outcomes and the need for re-evaluation after intervention.

American College of Cardiology

July 24, 2025

174 views

Comparison of FFR and iFR in Serial Coronary Disease Evaluation

Comparison of FFR and iFR in Serial Coronary Disease Evaluation

Dr. Divaka Perera discusses the SERIAL study, the first randomized comparison of FFR and iFR in serial coronary artery disease, highlighting the predictive accuracy of iFR over FFR in post-PCI outcomes and the need for re-evaluation after intervention.

aayshacader

July 14, 2025

86 views

  • Saad Ezad
    @SaadEzad (Twitter)

    RT @MissouriACC: In serial #cvCAD, both FFR & iFR pullbacks overestimate PCI benefit. Post-PCI physiology should be standard in diffuse/ser…
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    August 8, 2025

    2

  • Aish Sinha
    @AishSinha1 (Twitter)

    RT @MissouriACC: In serial #cvCAD, both FFR & iFR pullbacks overestimate PCI benefit. Post-PCI physiology should be standard in diffuse/ser…
    view full post

    August 8, 2025

    2

  • Kansas ACC
    @KansasACC (Twitter)

    In serial #cvCAD, both FFR & iFR pullbacks overestimate PCI benefit. Post-PCI physiology should be standard in diffuse/serial disease. Read @JACCJournals: https://t.co/xSkA52YswA @divaka_perera @mattlkw #JACCINT #InterventionalCardiology https://t.co/vsvzyOxFkC
    view full post

    August 8, 2025

    1

  • Missouri ACC
    @MissouriACC (Twitter)

    In serial #cvCAD, both FFR & iFR pullbacks overestimate PCI benefit. Post-PCI physiology should be standard in diffuse/serial disease. Read @JACCJournals: https://t.co/Rf1HrMWb2y @divaka_perera @mattlkw #JACCINT #InterventionalCardiology https://t.co/Cr8Mb1S44B
    view full post

    August 8, 2025

    10

    2

  • OklahomaACC
    @acc_oklahoma (Twitter)

    In serial #cvCAD, both FFR & iFR pullbacks overestimate PCI benefit. Post-PCI physiology should be standard in diffuse/serial disease. Read @JACCJournals: https://t.co/3bSQoZIPkn @divaka_perera @mattlkw #JACCINT #InterventionalCardiology https://t.co/2Sun2or76v
    view full post

    August 8, 2025

    1

  • IllinoisACC
    @IllinoisACC (Twitter)

    In serial #cvCAD, both FFR & iFR pullbacks overestimate PCI benefit. Post-PCI physiology should be standard in diffuse/serial disease. Read @JACCJournals: https://t.co/nfXuATRXEG @divaka_perera @mattlkw #JACCINT #InterventionalCardiology https://t.co/OilSwUbK7Z
    view full post

    August 8, 2025

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  • Bambang Dwiputra MD
    @sapporohunt (Twitter)

    Pullback gradients (FFRΔ, iFRΔ) significantly overestimate PCI benefit in serial/diffuse CAD, missing residual ischemia in ~1/3 of cases. FFRcalc performed better, but post-PCI FFR/iFR reassessment remains essential.
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    July 28, 2025

  • Cardiac Research
    @UKheartresearch (Twitter)

    RT @DrOzanDemir: Great work by the SERIAL Trial investigators
    view full post

    July 17, 2025

    1

  • Ozan M. Demir
    @DrOzanDemir (Twitter)

    Great work by the SERIAL Trial investigators
    view full post

    July 17, 2025

    13

    1

  • Emma Mae Fussell
    @emmamae_fussell (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 15, 2025

    15

  • Hany Ragy
    @Hragy (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 15, 2025

    15

  • Osama Bisht
    @Obisht (Twitter)

    RT @aayshacader: @divaka_perera shares insights from the SERIAL study: 1st randomized comparison of #FFR & #iFR in serial CAD
    view full post

    July 15, 2025

    6

  • Osama Bisht
    @Obisht (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 15, 2025

    15

  • Rajan Rehan
    @RajanRehan23 (Twitter)

    RT @mattlkw:
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    July 15, 2025

    13

  • John Mannisi MD
    @JMannisi (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 15, 2025

    15

  • Aish Sinha
    @AishSinha1 (Twitter)

    RT @aayshacader: @divaka_perera shares insights from the SERIAL study: 1st randomized comparison of #FFR & #iFR in serial CAD
    view full post

    July 15, 2025

    6

  • Aish Sinha
    @AishSinha1 (Twitter)

    RT @UKheartresearch: What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL tri…
    view full post

    July 15, 2025

    6

  • Biljana Parapid, MD, PhD, FESC
    @biljana_parapid (Twitter)

    RT @mattlkw:
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    July 15, 2025

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  • Hany Ragy
    @Hragy (Twitter)

    RT @mattlkw:
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  • Natsir Ramadhan
    @natsiradhan (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 15, 2025

    15

  • Damien Collison
    @DamienCollison (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 15, 2025

    15

  • Damien Collison
    @DamienCollison (Twitter)

    RT @mattlkw:
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    July 15, 2025

    13

  • Mona Tirén
    @monaltiren (Twitter)

    RT @UKheartresearch: What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL tri…
    view full post

    July 15, 2025

    6

  • Mona Tirén
    @monaltiren (Twitter)

    RT @aayshacader: @divaka_perera shares insights from the SERIAL study: 1st randomized comparison of #FFR & #iFR in serial CAD
    view full post

    July 15, 2025

    6

  • Kuchal Agadi
    @AgadiKuchal (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 14, 2025

    15

  • ranil de silva
    @ranildesilva2 (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
    view full post

    July 14, 2025

    15

  • trauma&vascular, sometimes cardiac
    @VascularTrauma (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 14, 2025

    15

  • Richard Bogle
    @richardbogle (Twitter)

    RT @mattlkw:
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    July 14, 2025

    13

  • Cardiac Research
    @UKheartresearch (Twitter)

    RT @aayshacader: @divaka_perera shares insights from the SERIAL study: 1st randomized comparison of #FFR & #iFR in serial CAD
    view full post

    July 14, 2025

    6

  • Divaka Perera
    @divaka_perera (Twitter)

    RT @aayshacader: @divaka_perera shares insights from the SERIAL study: 1st randomized comparison of #FFR & #iFR in serial CAD
    view full post

    July 14, 2025

    6

  • Solveig Grimstad
    @ViaDelSol (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 14, 2025

    15

  • Kalpa De Silva
    @K_DeSilva (Twitter)

    RT @mattlkw:
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    July 14, 2025

    13

  • Becker Al-Khayatt
    @beckeralkhayatt (Twitter)

    RT @UKheartresearch: What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL tri…
    view full post

    July 14, 2025

    6

  • Antonio de Marvao
    @AdeMarvao (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 14, 2025

    15

  • Aaysha Cader
    @aayshacader (Twitter)

    @divaka_perera shares insights from the SERIAL study: 1st randomized comparison of #FFR & #iFR in serial CAD
    view full post

    July 14, 2025

    11

    6

  • Dr Peter O'Kane
    @DrPeterOKane (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 14, 2025

    15

  • Dr Peter O'Kane
    @DrPeterOKane (Twitter)

    RT @mattlkw:
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    July 14, 2025

    13

  • Dr Peter O'Kane
    @DrPeterOKane (Twitter)

    RT @UKheartresearch: What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL tri…
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    July 14, 2025

    6

  • Sandeep Jalli
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    RT @mattlkw:
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  • REVIVED
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    RT @UKheartresearch: What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL tri…
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  • Divaka Perera
    @divaka_perera (Twitter)

    RT @UKheartresearch: What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL tri…
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    July 14, 2025

    6

  • Cardiac Research
    @UKheartresearch (Twitter)

    What better way to launch our @YouTube channel https://t.co/3tBw1ZZCUT than with a brilliant summary of the SERIAL trial by @mattlkw! https://t.co/aDbUGDfnOd https://t.co/A5pnZxVv45
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    July 14, 2025

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  • Matthew Li Kam Wa
    @mattlkw (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 14, 2025

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  • Divaka Perera
    @divaka_perera (Twitter)

    RT @JACCJournals: This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynam…
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    July 14, 2025

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  • JACC Journals
    @JACCJournals (Twitter)

    This first randomized comparison of FFR & iFR in serial #cvCAD shows that both FFR & iFR pullbacks overestimate hemodynamic benefits of #PCI. Post-PCI physiology should be routinely performed in diffuse & serial disease. https://t.co/oKY788cJrE @divaka_perera @mattlkw #JACCINT https://t.co/5KtQpjam6G
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    July 14, 2025

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Abstract Synopsis

  • The study compares Fractional Flow Reserve (FFR) and instantaneous wave-free ratio (iFR) in predicting the effectiveness of percutaneous coronary intervention (PCI) for patients with complex coronary artery issues.
  • It found that iFR provided more accurate predictions of post-PCI physiological outcomes than FFR, with less predictive error (4% vs. 12%).
  • The results suggest that both FFR and iFR can overlook significant residual disease in a notable percentage of cases, highlighting the importance of re-evaluating these metrics after PCI in patients with serial disease.