Arq. Bras. Cardiol. 2020; 115(4): 719
Temporal Evolution of the iFR (Instantaneous Wave-Free Ratio) Employment Results Analysis
Maria Cristina Meira Ferreira
, Gláucia Maria Moraes de Oliveira
Dear Editor,
We read with interest the short editorial written by authors Chamié and Abzaid regarding the paper “Evaluation of Myocardial Ischemia with iFR (instantaneous wave-free ratio) in the catheterization laboratory: a pilot study”. The short editorial clearly translates to us the historical evolution reasoning that we must follow when interpreting coronary physiology studies in therapeutic decision-making. Although medicine is full of binary situations for resolution, such as the presence or absence of fever by the thermometer, it is very clear that different levels of values refer to different diagnoses, prognosis and treatments. With regard to coronary functional assessments, after an enormous amount of binary studies to demonstrate their validity, recent trials cited in the short editorial directed us to a phase where clinical decision-making power has an important weight once again, and the dissertation of this change in direction occurred brilliantly in the editorial. We did not neglect the clinical reasoning and other factors in our study, since the stent placement predictor was iFR < 0.87 in this group, despite the cutoff value established for iFR being 0.89, with a significant reduction in the use of stent.
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