The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)


Assessing coronary disease in patients with severe aortic stenosis: the need for a ‘valid’ gold standard for validation studies?

EuroIntervention 2018;13:1499-1502. DOI: 10.4244/EIJV13I13A240

1. International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London, United Kingdom; 2. Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom

A significant proportion of patients with severe aortic stenosis have concomitant coronary disease1,2. The decision to intervene on such disease has traditionally been guided by angiographic appearance. Intracoronary physiology has been demonstrated to be more accurate than angiography when determining which stenoses need to be treated3. However, patients with significant valve disease have been excluded from all validation4,5 and randomised studies6,7 involving these tools. Therefore, the role of such techniques in these patients is yet to be determined. In this issue of EuroIntervention, Scarsini et al8 compare diagnostic categorisation of the instantaneous wave-free ratio (iFR) to fractional flow reserve (...

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