VIDEO: Intervention highlights from ACC

In this Cardiology Today video perspective, Deepak L. Bhatt, MD, MPH, chief medical editor of Cardiology Today’s Intervention, shares his thoughts on the major findings in interventional cardiology presented at the American College of Cardiology Scientific Session.

Two trials, DEFINE-FLAIR and IFR-SWEDEHEART, compared instantaneous wave-free ratio (iFR) vs. fractional flow reserve (FFR) with positive results.

“I’m excited because iFR is a lot easier to do than FFR,” Bhatt said. “It’s quicker; it’s easier. There’s less patient discomfort and no need to give adenosine.”

Additionally, iFR is helpful for multiple lesions and is linked to less stent usage, which is beneficial for the patient, he said.

“For a variety of reasons, I actually think this is a big win and could be practice-changing,” he said. “And it could increase the overall use of invasive physiologic assessment in the cath lab.”

Another study, COMPARE ACUTE, concerned FFR of nonculprit lesions in patients with STEMI as a means to decide on complete revascularization. The study found that an FFR-guided complete revascularization strategy significantly reduced MACE.

“The study is supportive of complete revascularization patients in STEMI patients and supportive of the use of FFR and maybe IFR, by extrapolation from the other two studies in that setting,” Bhatt said.

He said the results of ABSORB III, a study of bioabsorbable scaffold (Absorb BVS, Abbott Vascular) vs. a second-generation drug-eluting stent (Xience, Abbott Vascular), were not encouraging.

“It really isn’t clear to me what patient would have a compelling indication in 2017 for the current-generation bioabsorbable scaffold,” Bhatt said. “If you’re going to go ahead and implant it, I just say be cautious, think twice and have a good justification for it.”