Long-term outcomes after resting full-cycle ratio and deferral of revascularization
By
Stephan Nienaber
Jakob Wind
Philipp Lake
Victor Mauri
M. Adam
Karl Finke
Henning Guthoff
Stephan Baldus
Marcel Halbach
Hendrik Wienemann
July 7, 2026
Clinical Scorecard: Long-term Effects of Full-Cycle Ratio Assessment and the Decision to Delay Revascularization
At a Glance
Category Detail
Condition Coronary artery disease (CAD) Key Mechanisms Assessment of coronary stenosis using resting full-cycle ratio (RFR) and non-hyperemic pressure ratios (NHPR) Target Population Patients with angiographically intermediate coronary artery disease Care Setting Tertiary heart center
Key Highlights
CAD accounts for 35-40% of cardiovascular-related deaths in the EU and US. RFR assessment allows deferral of revascularization in non-ischemic cases. RFR ≤ 0.89 indicates myocardial ischemia; RFR > 0.89 supports deferral of intervention. Long-term outcomes of RFR assessment show low incidence of major adverse cardiac events (MACE). Current guidelines endorse FFR, but RFR is emerging as a viable alternative. Guideline-Based Recommendations
Diagnosis
Use of RFR for assessing functional significance of coronary stenoses. Management
Deferral of revascularization based on RFR values. Monitoring & Follow-up
Follow-up on MACE incidence at 2 years post-assessment. Risks
Potential for misclassification of ischemia in hemodynamically unstable patients. Patient & Prescribing Data
773 patients with angiographically intermediate CAD
RFR measurement is standard for assessing coronary stenoses; deferral based on RFR values is clinically supported.
Clinical Best Practices
Adhere to predefined RFR cutoff values during assessments. Conduct assessments in accordance with current guidelines and protocols. Related Resources & Content
