Impact of Interventional Revascularization on the Physiological Assessment of Bystander Coronary Lesions by FFR (ABC-FFR)

Impact of Interventional Revascularization on the Physiological Assessment of Bystander Coronary Lesions by FFR (ABC-FFR)

The ABC-FFR trial examines the understudied hemodynamic interaction between parallel coronary stenoses, as the physiological impact of treating one lesion on the pressure indices of lesions in separate parallel branches is not yet fully understood. This prospective, multicenter study enrolls patients scheduled for percutaneous coronary intervention (PCI) of a designated index lesion who also present with a concurrent remote stenosis in a parallel coronary artery. It evaluates potential changes in fractional flow reserve (FFR) and non-hyperemic pressure ratio (NHPR) measurements within the remote lesion both before and after the index lesion is revascularized.

Study Overview

• Status: Completed
• Conditions: Coronary Artery Disease
• Intervention / Treatment: Diagnostic test: Hemodynamic Evaluation of Remote Lesion before & after PCI of Index Lesion

• Study Type: Observational
• Enrollment (Actual): 160

Contacts and Locations

Study Locations

• Germany
  • Burgebrach, Germany, 96138
    • Steigerwaldklinik Burgebrach
  • Dortmund, Germany, 44137
    • Department of Medicine 1 - Cardiology, Nephrology, Intensive Care and Rhythmology, St. Johannes Hospital Dortmund
  • Erlangen, Germany, 91054
    • Deparment of Medicine 2 - Cardiology and Angiology, Friedrich-Alexander-Universität Erlangen-Nürnberg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Patients who were scheduled for percutaneous coronary intervention of at least one coronary index stenosis and had at least one additional remote stenosis in a parallel coronary artery

Description

Inclusion Criteria:

• Age ≥ 18 years
• Scheduled percutaneous coronary intervention for at least one coronary lesion (as indicated by evidence of myocardial ischemia on non-invasive stress imaging, an angiographic stenosis severity >90% diameter stenosis, or an hemodynamically significant intracoronary pressure measurement)
• Additional stenosis of ≥ 30% diameter stenosis in a parallel coronary artery anatomically suitable for wire-based intracoronary pressure assessment

Exclusion Criteria:

• ST-elevation myocardial infarction
• Non-ST-elevation myocardial infarction with immediate invasive strategy recommended by current ESC guidelines (e.g. due to hemodynamic instability, cardiogenic shock, acute heart failure presumed secondary to ongoing myocardial ischemia, recurrent or ongoing chest pain refractory to medical treatment, or life-threatening arrhythmias or cardiac arrest after presentation)
• Acute totally occluded coronary artery
• Unsuitability for intracoronary measurement of FFR (e.g. due to contraindications for the administration of adenosine)

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ΔFFR	Difference between fractional flow reserve measurements in the remote lesion after and before percutaneous coronary intervention of the index lesion	Baseline
Change in Hemodynamic Classification by FFR	Change in hemodynamic classification of the remote lesion with fractional flow reserve after percutaneous coronary intervention of the index lesion	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ΔNHPR	Difference between non-hyperemic pressure ratio measurements in the remote lesion after and before percutaneous coronary intervention of the index lesion	Baseline
Change in Hemodynamic Classification by NHPR	Change in hemodynamic classification of the remote lesion with non-hyperemic pressure ratios after percutaneous coronary intervention of the index lesion	Baseline

Collaborators and Investigators

• Sponsor: Friedrich-Alexander-Universität Erlangen-Nürnberg
• Collaborators: University of Erlangen-Nürnberg Medical School; University Hospital Erlangen

Study record dates

Study Major Dates

• Study Start (Actual): June 10, 2020
• Primary Completion (Actual): June 26, 2025
• Study Completion (Actual): June 26, 2025

Study Registration Dates

• First Submitted: December 18, 2025
• First Submitted That Met QC Criteria: December 18, 2025
• First Posted (Estimated): January 2, 2026

Study Record Updates

• Last Update Posted (Estimated): January 2, 2026
• Last Update Submitted That Met QC Criteria: December 18, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Fractional Flow Reserve (FFR); Cardiology; Chronic Coronary Syndrome (CCS); Intracoronary Pressure Measurement; Instantaneous Wave-Free Ratio (iFR); Resting Full-Cycle Ratio (RFR)
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Heart Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Myocardial Ischemia; Coronary Artery Disease
• Other Study ID Numbers: 12_21 Bc

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Privacy and ethical restrictions

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No