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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Functional assessment of coronary lesions by fractional flow reserve &#40;FFR&#41; is common practice in percutaneous coronary intervention &#40;PCI&#41; and is formally recommended in the European guidelines&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> Various studies have shown that the use of FFR to guide decision-making helps detect cases in which it is safe not to perform PCI&#46;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">2&#8211;4</span></a> A Portuguese multicenter registry recently obtained similar results&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">5</span></a> Nevertheless&#44; there is still no absolute consensus regarding the ideal FFR cutoff for deciding whether to perform PCI&#46; Most trials use a cutoff of &#8804;0&#46;80&#44;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">2&#44;3</span></a> but the study with the longest follow-up used a value of &#60;0&#46;75 to proceed with PCI&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In recent years&#44; a new functional assessment technique &#8211; the instantaneous wave-free ratio &#40;iFR&#41; &#8211; has emerged as an alternative to FFR&#46; Its advantages are that it does not require drugs such as adenosine&#44; and results can be obtained more rapidly than with FFR&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">6</span></a> Various studies have indicated good concordance between iFR and FFR&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">7&#44;8</span></a> Two recent randomized multicenter clinical trials demonstrated the non-inferiority of iFR compared to FFR with regard to outcomes for deciding whether to perform PCI&#44; using a cutoff of &#8804;0&#46;89 for iFR as an indication to perform the procedure&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">9&#44;10</span></a> Other trials have examined a hybrid strategy&#44; in which PCI is performed with iFR &#60;0&#46;86&#44; a conservative approach is adopted for &#62;0&#46;93&#44; and assessment by FFR is carried out in cases with values between these cutoffs&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a> However&#44; there is no consensus regarding the use of iFR only&#44; nor on how to interpret its results&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">11</span></a> FFR is still considered the gold standard for the functional assessment of coronary lesions&#44; including in international guidelines&#46;<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">1&#44;11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">We therefore set out to analyze the results of a registry on the use of iFR and FFR to determine &#40;1&#41; the diagnostic accuracy of iFR using FFR as a reference&#44; &#40;2&#41; the effect of using iFR initially on the decision to perform FFR at the discretion of the operator&#44; &#40;3&#41; the degree of concordance between the two techniques&#44; and &#40;4&#41; the effect of using iFR on fluoroscopy time&#44; radiation dose and procedure time&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study characteristics</span><p id="par0020" class="elsevierStylePara elsevierViewall">This was a single-center registry of all patients who underwent coronary angiography with functional assessment of coronary lesions by FFR and&#47;or iFR over a five-year period &#40;2012-2016&#41;&#46; Whether to perform FFR&#44; iFR or both was left to the operator&#39;s discretion&#44; as was the decision whether to proceed to revascularization or medical treatment&#46; Patients enrolled in clinical trials involving these techniques were excluded&#44; since they were subject to specific protocols that did not rely on the operator&#39;s decision&#46; Demographic&#44; clinical and procedural characteristics were recorded prospectively&#44; including FFR and iFR measurements and their results&#46; This study is a retrospective analysis&#44; since it focused mainly on the subgroup who underwent both measurements&#44; and the registry was not created specifically for the purpose of comparing the two groups&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Measurement of fractional flow reserve and instantaneous wave-free ratio</span><p id="par0025" class="elsevierStylePara elsevierViewall">FFR was measured after maximum hyperemia was obtained by central venous administration of adenosine &#40;140 &#956;g&#47;kg&#47;min&#41;&#44; using St&#46; Jude Medical &#40;now Abbot&#41; or Volcano &#40;now Philips Volcano&#41; systems&#46; The latter &#40;console and other equipment&#41; was used in all cases when iFR was measured alone or jointly with FFR&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Statistical analysis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Receiver operating characteristic curve analysis was used to identify the iFR value with the best diagnostic accuracy&#44; using FFR as a reference with cutoffs of &#8804;0&#46;80 and &#60;0&#46;75&#46; Bland-Altman plots and Pearson&#39;s correlation were used to compare iFR and FFR values&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">iFR results were also compared according to the hybrid strategy&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a> in which a value between 0&#46;86 and 0&#46;93 was considered inconclusive&#44; &#60;0&#46;86 was considered positive &#40;indicating ischemia and therefore PCI&#41;&#44; and &#62;0&#46;93 was considered negative &#40;indicating absence of ischemia&#44; and hence deferral of the procedure&#41;&#46; The same assessment was carried out using a cutoff of &#8804;0&#46;89 in accordance with two recent randomized trials&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">9&#44;12</span></a> Both analyses used a cutoff of &#8804;0&#46;80 for FFR as a reference&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Finally&#44; the effect of iFR on fluoroscopy time&#44; radiation dose&#44; procedure time and use of adenosine was analyzed&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The Student&#39;s t test was used to compare quantitative variables and the chi-square test was used to compare qualitative variables&#46; Values are presented as mean &#177; standard deviation &#40;SD&#41;&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Results</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Population and procedural characteristics</span><p id="par0050" class="elsevierStylePara elsevierViewall">Over a five-year period&#44; 326 patients &#40;mean age 67&#177;11 years&#44; 68&#46;7&#37; male&#41; underwent functional assessment of moderate coronary lesions&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Measurements were taken for 402 lesions&#46; FFR was used to assess 376 &#40;93&#46;5&#37;&#41; lesions and iFR to assess 180 &#40;44&#46;8&#37;&#41;&#44; with FFR only used in 222 lesion &#40;55&#46;2&#37;&#41; and iFR only in 26 lesion &#40;6&#46;5&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#46; There were no complications arising from adenosine use&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the main demographic and clinical characteristics of the patients in the overall population and according to the use of FFR&#44; iFR or both techniques&#46; There was a higher prevalence of dyslipidemia in the iFR-only group than in the FFR-only group&#44; and a higher prevalence of previous history of myocardial infarction &#40;almost reaching statistical significance&#44; p&#61;0&#46;05&#41; and previous PCI &#40;p&#61;0&#46;034&#41; in the FFR-only group vs&#46; the group in which both techniques were used&#46; There were no other significant differences between the groups&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">In cases of non-ST-elevation acute coronary syndrome&#44; the measurements taken were of non-culprit lesions and were performed 48-72 hours after symptom onset&#44; while in ST-elevation acute coronary syndrome&#44; six non-culprit lesions were assessed&#44; all during the acute phase&#46; Four of these assessments used both techniques and two used FFR only&#44; with the FFR result used for decision-making&#46; Of the four iFR measurements&#44; three lesions had iFR 0&#46;9 &#40;two cases with positive and one with negative FFR&#41;&#44; and the fourth had iFR 0&#46;88 &#40;FFR 0&#46;81&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the characteristics of the lesions assessed&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Diagnostic accuracy of fractional flow reserve and instantaneous wave-free ratio</span><p id="par0070" class="elsevierStylePara elsevierViewall">Mean iFR was 0&#46;90&#177;0&#46;1&#44; and was &#62;0&#46;93 in 60 cases &#40;33&#46;3&#37; of all measurements&#41; and &#60;0&#46;86 in 21 cases &#40;11&#46;7&#37; of all measurements&#41;&#46; In the iFR-only subgroup&#44; all values were &#60;0&#46;86 or &#62;0&#46;93&#44; so calculating the mean and SD does not represent its true distribution &#40;iFR-only was the only subgroup without a normal distribution&#41;&#59; when both techniques were used&#44; mean iFR was 0&#46;9&#177;0&#46;05&#46; Mean FFR in the overall population was 0&#46;82&#177;0&#46;08&#46; No statistically significant differences were found between mean FFR for FFR-only cases &#40;0&#46;81&#177;0&#46;09&#41; and cases in which both techniques were used &#40;0&#46;82&#177;0&#46;07&#41;&#46; <a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> shows the distribution of overall iFR and FFR values&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">A moderately significant correlation was found between iFR and FFR &#40;R&#61;0&#46;504&#59; p&#60;0&#46;001&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#44; as shown in the scatter plot&#46; Bland-Altman analysis showed good concordance &#40;the mean difference between iFR and FFR was 0&#46;085&#177;0&#46;062&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">In terms of diagnostic accuracy&#44; the area under the curve &#40;AUC&#41; of iFR was 0&#46;73 &#40;95&#37; CI&#58; 0&#46;65-0&#46;81&#41; and 0&#46;72 &#40;95&#37; CI&#58; 0&#46;60-0&#46;84&#41;&#44; using cutoffs of &#8804;0&#46;80 and &#60;0&#46;75&#44; respectively&#44; for FFR as reference &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Figure 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">The optimal iFR cutoff was found to be &#8804;0&#46;91 for both FFR &#8804;0&#46;80 &#40;55&#37; sensitivity&#44; 79&#37; specificity&#44; 52&#37; positive predictive value&#44; 81&#37; negative predictive value&#41; and FFR &#60;0&#46;75 &#40;47&#37; sensitivity&#44; 89&#37; specificity&#44; 19&#37; positive predictive value&#44; 97&#37; negative predictive value&#41;&#46; In addition&#44; for FFR &#8804;0&#46;80&#44; the iFR range with sensitivity and specificity &#62;90&#37; was 0&#46;88-0&#46;94&#44; and for FFR &#8804;0&#46;75 it was 0&#46;87-0&#46;95&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Effect of instantaneous wave-free ratio measurements on the decision to measure fractional flow reserve and concordance of results</span><p id="par0090" class="elsevierStylePara elsevierViewall">An iFR between 0&#46;86 and 0&#46;93 was strongly associated with the decision to perform FFR &#40;chi-square&#61;30&#46;1&#59; p&#60;0&#46;001&#41;&#44; which occurred in 93 out of 94 cases&#46; When iFR was not within this range&#44; the decision to assess the lesion by FFR was made in 55 cases &#40;69&#46;1&#37;&#41;&#46; No differences were found in the decision to perform FFR in this subgroup between iFR results of &#60;0&#46;86 vs&#46; &#62;0&#46;93 &#40;71&#46;4&#37; vs&#46; 68&#37;&#59; p&#61;0&#46;792&#41;&#46; In these cases&#44; a statistically significant concordance of 87&#46;3&#37; was found between iFR and FFR results &#40;chi-square&#61;22&#46;43&#59; p&#60;0&#46;001&#41;&#46; However&#44; there was discordance between the two methods in four out of 13 &#40;30&#46;8&#37;&#41; cases of positive iFR with negative FFR&#44; and in three out of 42 &#40;7&#46;1&#37;&#41; cases with negative iFR and positive FFR&#46; This difference was statistically significant &#40;p&#61;0&#46;026&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Figure 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">These discrepancies are detailed in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Four of them were in measurements of the left anterior descending artery &#40;16&#37; of a total of 25 measurements in this artery&#41;&#44; two in the right coronary artery &#40;14&#37; of 14 measurements&#41; and one in the circumflex artery &#40;6&#46;7&#37; of 15 measurements&#41;&#46; There was only one measurement using both techniques in the left main&#44; with no discordance&#46; As can be seen&#44; in cases of negative iFR and positive FFR&#44; the operators chose to follow the FFR indication when the measurement was clearly less than 0&#46;80&#46; In case 3&#44; the presence of a borderline value led the operator to defer the procedure&#46; In cases of positive iFR&#44; the operators followed the indication given by FFR&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Concordance of results according to instantaneous wave-free ratio cutoff of 0&#46;89</span><p id="par0100" class="elsevierStylePara elsevierViewall">Using an iFR cutoff of 0&#46;89&#44; 56 lesions &#40;36&#46;4&#37;&#41; were positive &#40;&#8804;0&#46;89&#41; and 98 &#40;73&#46;6&#37;&#41; were negative &#40;&#62;0&#46;89&#41;&#46; A statistically significant concordance of 72&#46;1&#37; &#40;p&#60;0&#46;001&#41; was found between the two techniques&#44; while no significant differences were found between cases of positive iFR with negative FFR &#40;20 out of 43 cases&#59; 46&#46;5&#37;&#41; and negative iFR with positive FFR &#40;23 out of 43 cases&#59; 53&#46;5&#37;&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Results of the assessment and treatment decisions</span><p id="par0105" class="elsevierStylePara elsevierViewall">The decision whether to proceed with revascularization was taken by each operator individually for each patient&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">In the 26 cases in which iFR only was performed&#44; all values were outside the gray area &#40;seven cases &#60;0&#46;86&#44; all others &#62;0&#46;93&#41;&#44; and the decision on revascularization was made according to the iFR result&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">When FFR only was performed&#44; the treatment decision was made according to the FFR result &#40;cutoff 0&#46;80&#41; in 97&#46;7&#37; of cases&#46; In the other 2&#46;3&#37;&#44; the operator decided not to act on the FFR value due to other relevant data&#44; such as lesion characteristics&#44; symptoms&#44; or results of non-invasive ischemia tests&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">When both techniques were performed&#44; the operators followed the results whenever there was concordance between the two techniques&#46; Cases in which there was discordance are described above &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Effects of the method used on fluoroscopy time&#44; radiation dose and procedure time</span><p id="par0125" class="elsevierStylePara elsevierViewall">No statistically significant differences were found in fluoroscopy time&#44; radiation dose or procedure time between patients who underwent iFR only and those who underwent FFR only&#44; or between those who underwent both iFR and FFR and those who underwent only one technique &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Effects of the method used on adenosine use</span><p id="par0130" class="elsevierStylePara elsevierViewall">Considering only patients who underwent iFR only or both iFR and FFR &#40;a total of 147&#41;&#44; 55 &#40;37&#46;4&#37;&#41; of them had all lesions assessed and had a conclusive iFR measurement &#40;outside of the 0&#46;86-0&#46;93 range&#41;&#46; With the hybrid strategy&#44; the use of adenosine in these patients would have been avoided&#46;</p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Performance of instantaneous wave-free ratio with fractional flow reserve as the gold standard</span><p id="par0135" class="elsevierStylePara elsevierViewall">In this registry&#44; iFR showed reasonable diagnostic accuracy and concordance with FFR&#44; although there were some differences from previous publications&#46; The best cutoff in this sample was slightly higher than that published in other studies &#40;0&#46;91 vs&#46; 0&#46;89<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">7&#44;13</span></a>&#41;&#44; regardless of the FFR value used as standard&#46; In addition&#44; its diagnostic accuracy was inferior to that of some other studies&#44; in which the AUC ranged from 0&#46;86 to 0&#46;90&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">7&#44;13&#44;14</span></a> but better than in the VERIFY study&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">15</span></a> The correlation between iFR and FFR was also lower than in previous studies &#40;0&#46;504&#44; compared to 0&#46;81 in ADVISE II<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a>&#41;&#46; These results may reflect a sample-size effect&#44; since our population was smaller than in the other studies&#44; or selection bias&#44; since the study was based on a registry&#46; Operators may have chosen to use both measurements in particularly borderline cases&#44; as can be seen by the fact that the mean iFR value was very similar to the diagnostic value used in DEFINE-FLAIR<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a> and iFR-SWEDEHEART<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">12</span></a> &#40;0&#46;89&#41;&#46; Furthermore&#44; when iFR was performed first and the result was then confirmed using FFR&#44; not only was the value borderline&#44; the SD was also very small &#40;0&#46;05&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Concordance between instantaneous wave-free ratio and fractional flow reserve and implications for daily practice</span><p id="par0140" class="elsevierStylePara elsevierViewall">When the hybrid strategy was used&#44; iFR showed high concordance within the diagnostic range &#40;&#60;0&#46;86 and &#62;0&#46;93&#41;&#46; This is similar to the results of the study by Escaned et al&#46; that properly classified 91&#46;6&#37; of stenoses&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a> which was slightly higher than in our case &#40;87&#37;&#41;&#46; When a cutoff of 0&#46;89 was used&#44; the degree of concordance was also lower than in Escaned et al&#46; &#40;72&#46;1&#37; vs&#46; 82&#46;5&#37;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a>&#41;&#44; because this cutoff did not have the highest diagnostic accuracy in this sample &#40;which limits the extent to which this result can be generalized&#41;&#44; as well as the above-mentioned limitations&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Notwithstanding the good results from the hybrid approach in this registry&#44; the degree of discrepancy between the two techniques was not negligible&#46; When iFR and FFR gave different indications&#44; operators tended to follow current international guidelines<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">1</span></a> and use FFR as the gold standard&#46; Discordance predominantly involved positive iFR and negative FFR&#44; as in other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a> Thus&#44; it may particularly important for the operator to proceed with FFR in borderline cases&#44; especially when iFR is positive&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The recently published results of DEFINE-FLAIR<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a> and iFR-SWEDEHEART<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">10</span></a> have for the first time provided solid evidence in favor of decision-making based only on iFR &#8804;0&#46;89&#46; At the same time&#44; despite the unfavorable results of the FUTURE trial&#44;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">16</span></a> the experience gained with FFR and the extensive literature on this technique cannot be ignored&#46; Thus&#44; if there are to be large multicenter randomized trials on the use of both techniques&#44; two key issues must be addressed&#58; what to do if the FFR and iFR results do not agree&#44; and whether only one of the techniques should be used and&#44; if so&#44; which&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">In the absence of agreement on the answers to these questions&#44; certain points should be taken into consideration in order to arrive at the best decision in each case&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Firstly&#44; the operator must ensure that the technique is performed correctly&#44; with appropriate caliber&#44; type and positioning of the catheter&#44; to avoid attenuation or distortion of the pressure curves&#44; and that pressures are correctly calibrated to ensure that the curves overlap in time and in quantity&#44; synchronized with the electrocardiogram&#46; Although both techniques are influenced by these factors&#44; faults in execution may distort one measurement more or less than the other&#46; For example&#44; in iFR&#44; failure to synchronize with the electrocardiogram can mean that the timing of the distal coronary pressure to aortic pressure ratio &#40;Pd&#47;Pa&#41; reading is inaccurate&#44; leading to non-diastolic or partially diastolic values being incorporated into the result&#46; Another problem to consider is pressure drift&#59; to correct this&#44; the operator should confirm that the pressure curves overlap before ending the procedure and&#44; if necessary&#44; reposition the pressure wire proximally&#46; Finally&#44; it should be noted that the only iFR systems currently available are from Volcano Philips&#44; and so all iFR measurements in our study were performed using this equipment&#59; any measurement taken using other systems remains off-label&#46; It should borne in mind that in our registry&#44; the centers and all its operators were thoroughly experienced in the use of FFR&#44; so we can assume that the error rate was low&#46; Nevertheless&#44; the possibility of inaccuracies in iFR measurements cannot be completely excluded&#44; especially while the new technique was being introduced&#46; Furthermore&#44; although confirmation of the absence of pressure drift is routine practice at our site&#44; no record was kept of this&#46; Similarly&#44; although measurements in which the electrocardiographic tracing was suboptimal were rejected and iFR was rarely used in patients with atrial fibrillation or flutter &#40;in none of whom discordance between the two techniques was observed&#41;&#44; the possibility that cardiac rhythm influenced some of the results cannot be completely ruled out&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Secondly&#44; even if there are no technical failures&#44; the physiology of what is being measured is relevant&#46; Since FFR is dependent on maximal hyperemia&#44; response can be affected by the drug used &#40;some centers use vasodilators other than adenosine&#41; and its administration route&#44;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">17</span></a> the vasodilatory effect of the contrast itself&#44;<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">18</span></a> the presence of concomitant microcirculatory dysfunction&#44;<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">19&#44;20</span></a> and adenosine&#39;s systemic vasodilatory effect&#46; The response to the drug&#44; at the level of both small and large coronary arteries as well as systemically&#44; is also known to vary between individuals&#44; especially in acute coronary syndrome&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Finally&#44; it should be noted that steady-state FFR often does not match the nadir value&#44; and so the former should be used&#44;<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">21</span></a> as in this registry&#46; In our study&#44; there were only five cases of discordance when the hybrid strategy was used in stable angina and two in acute coronary syndrome &#40;both unstable angina&#41;&#44; and so the clinical context likely had little effect on discordance&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">The limitations governing the use of iFR should also be taken into account&#46; Although iFR is not considered to be limited by hyperemia&#44; Berry et al&#46; dispute this and also claim that its diagnostic accuracy is lower than observed in other studies&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">15</span></a> In addition&#44; recent randomized trials had few events and were non-inferiority studies in which the non-inferiority margin was relatively wide&#44; as the authors acknowledged&#46;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">9&#44;10</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Some authors suggest that the discrepancy between the two methods is greater in lesions involving the anterior descending artery&#44;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">22</span></a> especially in its proximal segment&#46;<a class="elsevierStyleCrossRef" href="#bib0235"><span class="elsevierStyleSup">23</span></a> Given the low number of discordant findings in each vessel in our registry&#44; it is not possible to draw conclusions about the effect of the vessels or segments involved&#46; Even in the anterior descending&#44; there were only four cases of discrepancy&#44; a similar rate to that in the right coronary&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">The results from our registry&#44; together with findings in the literature&#44; thus suggest that iFR and FFR are in fact complementary methods for the assessment of coronary lesions&#44; and are not mutually exclusive&#46; Initial assessment by iFR only appears to be the most sensible strategy&#44; given its simplicity and speed of execution&#46; However&#44; the limitations of the above-mentioned studies suggest that caution is in order and that in doubtful cases operators should consider FFR as well&#46; Concordance between the two values is a strong indicator when deciding whether to proceed with revascularization&#46; Understanding the cause of any discrepancy is crucial in order to decide if one of the results is more valid for an individual lesion and patient&#46; If the cause is unclear&#44; the additional use of invasive and&#47;or non-invasive imaging methods should be considered before reaching a final decision&#44; especially as iFR and FFR have mainly been validated for stable coronary artery disease&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Effect of instantaneous wave-free ratio on fluoroscopy time&#44; radiation dose and procedure time</span><p id="par0190" class="elsevierStylePara elsevierViewall">In addition to not requiring adenosine&#44; one of the theoretical advantages of iFR is that it may reduce procedure time&#46; However&#44; there is little evidence in the literature to support this&#46; Although the DEFINE-FLAIR study<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a> reported a significant reduction of 4 min 30 s min with iFR compared to FFR&#44; the reduction was not significant in the iFR-SWEDEHEART study&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">10</span></a> As in the latter study&#44; in our registry the technique did not affect this or other parameters &#40;radiation dose and fluoroscopy time&#41;&#46; This may be explained by the significant differences between the patients studied&#44; with the operator opting for a simpler technique in more severe cases&#46; Nevertheless&#44; there were few statistically significant differences between the groups&#58; absolute and relative differences were small and had little statistical significance or clinical relevance&#44; and appeared to be unrelated to the operators&#8217; decisions&#46; In addition&#44; few patients underwent iFR only&#44; which also limits comparisons between groups&#46; Furthermore&#44; in each group&#44; in some cases more than one lesion was assessed&#46; This may have contributed to the numerical differences between the groups&#44; although these were not statistically significant&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Finally&#44; the apparent discrepancy &#40;not statistically significant&#41; between radiation dose and procedure time &#40;longer procedure time but lower radiation dose in the iFR group&#41; resulted from the use of different frame rates by different operators&#44; so the radiation dose did not always correspond to the fluoroscopy duration&#46; Between groups&#44; it was found that longer fluoroscopy duration was not associated with increased radiation dose&#46; This is why we opted to present data on both groups&#46;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Effect of instantaneous wave-free ratio on adenosine use</span><p id="par0200" class="elsevierStylePara elsevierViewall">In this registry&#44; iFR was used at the operator&#39;s discretion&#44; and especially in the early stages of its implementation&#44; both techniques were commonly used&#44; which resulted in a high rate of adenosine use&#46; As pointed out in the Results section&#44; if the hybrid strategy had been followed&#44; the use of adenosine could have been avoided in almost 40&#37; of patients&#46; This figure is still lower than in other studies&#44; particularly the ADVISE II study&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">7</span></a> in which the hybrid strategy led to 65&#46;1&#37; of patients not being administered adenosine&#46; The difference between these figures is related to the observational nature of our study&#44; in which there were no set criteria for selecting techniques&#44; and which could have led to selection bias in cases with borderline iFR values&#46;</p></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Limitations</span><p id="par0205" class="elsevierStylePara elsevierViewall">Differences between the results of our study and of others may result partly from the study characteristics&#44; as this was a registry and not a randomized clinical trial&#44; and thus the decision to use iFR or FFR was entirely at the operator&#39;s discretion&#46; Registries also do not have the same methodological rigor as clinical trials&#44; and so some results may have been affected by technical failings&#44; especially during the initial stage of implementation of the iFR technique&#44; as mentioned above&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Furthermore&#44; analysis using the cutoff of 0&#46;89 proposed in DEFINE-FLAIR<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">9</span></a> and iFR-SWEDEHEART<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">10</span></a> was limited by the fact that this was not the cutoff with the best diagnostic accuracy in our study&#44; due to the sample size and possible selection bias&#44; as pointed out above&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Finally&#44; patients with acute coronary syndrome were included&#44; and this may have affected the results&#46; However&#44; measurements in patients with non-ST-elevation acute coronary syndrome were performed 48-72 hours after symptom onset&#44; as in other studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">9&#44;12</span></a> which makes it less likely that our results were affected&#46; In patients with ST-elevation myocardial infarction &#40;STEMI&#41;&#44; six measurements were taken in the acute phase&#46; Although there is a high level of evidence from a recent randomized trial in favor of FFR in this context&#44;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">24</span></a> there is still no consensus on its use &#40;during our registry&#44; the only evidence in favor of FFR was observational and its advantages were only theoretical&#41;&#44; and the use of iFR in STEMI remains off-label&#46; Nevertheless&#44; in our study the borderline results of iFR did not constitute cases of discordance according to the hybrid strategy&#46; They were a very small proportion of the total sample in both absolute and relative terms&#44; and the indication provided by FFR was always followed&#44; not treating lesions for which intervention was not indicated &#40;bearing in mind that FFR tends to underestimate lesion severity&#41;&#46; We therefore do not consider that the cases of acute coronary syndrome significantly affected our results&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Conclusion</span><p id="par0220" class="elsevierStylePara elsevierViewall">iFR showed reasonable diagnostic accuracy and concordance with FFR&#44; although not as good as in most other studies&#46; The cut-offs with the best diagnostic accuracy were similar to those in the literature&#44; although slightly higher&#46; The use of an FFR cutoff of &#60;0&#46;75 instead of &#8804;0&#46;80 had a negative impact&#44; albeit a very small one&#44; on the diagnostic performance of iFR&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">iFR was frequently inconclusive when the hybrid strategy was applied&#46; In conclusive cases&#44; there was good concordance between iFR and FFR results&#46; However&#44; the proportion of cases of discordance was significant&#44; especially in assessments classified as positive by iFR and negative by FFR&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">The use of iFR did not have a significant effect on fluoroscopy time&#44; radiation dose or procedure time&#44; but it could have resulted in a significant reduction in the use of adenosine if the hybrid strategy had been applied&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">Although iFR is simple to perform and useful&#44; data from our registry suggest that its results should be interpreted with caution&#44; and the use of FFR should not be completely abandoned&#46; Both methods can in fact have significant gray areas in which interpretation of their results is ambiguous&#44; so other invasive or non-invasive methods for assessing coronary artery disease should always be considered&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conflicts of interest</span><p id="par0240" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
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              "titulo" => "Measurement of fractional flow reserve and instantaneous wave-free ratio"
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              "titulo" => "Population and procedural characteristics"
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              "titulo" => "Diagnostic accuracy of fractional flow reserve and instantaneous wave-free ratio"
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              "titulo" => "Effect of instantaneous wave-free ratio measurements on the decision to measure fractional flow reserve and concordance of results"
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              "titulo" => "Concordance of results according to instantaneous wave-free ratio cutoff of 0&#46;89"
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              "titulo" => "Results of the assessment and treatment decisions"
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              "titulo" => "Performance of instantaneous wave-free ratio with fractional flow reserve as the gold standard"
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              "titulo" => "Concordance between instantaneous wave-free ratio and fractional flow reserve and implications for daily practice"
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              "titulo" => "Effect of instantaneous wave-free ratio on fluoroscopy time&#44; radiation dose and procedure time"
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              "titulo" => "Effect of instantaneous wave-free ratio on adenosine use"
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            1 => "Fractional flow reserve"
            2 => "Invasive functional assessment of coronary lesions"
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            0 => "<span class="elsevierStyleItalic">Instantaneous wave-free ratio</span>"
            1 => "<span class="elsevierStyleItalic">Fractional flow reserve</span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Assessment of coronary lesions by the instantaneous wave free ratio &#40;iFR&#41; has generated significant debate&#46; We aimed to assess the diagnostic performance of iFR and its impact on the decision to use fractional flow reserve &#40;FFR&#41; and on procedural characteristics&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In this single-center registry of patients undergoing functional assessment of coronary lesions&#44; FFR was used as a reference for assessing the diagnostic performance of iFR&#46; An iFR value &#60;0&#46;86 was considered positive and a value &#62;0&#46;93 was considered negative&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Functional testing was undertaken of 402 lesions&#44; of which 154 were assessed with both techniques&#44; 222 with FFR only&#44; and 26 with iFR only&#46; Using a cut-off of &#8804;0&#46;80 for iFR&#44; the area under the curve was 0&#46;73 &#40;95&#37; CI 0&#46;65-0&#46;81&#41;&#44; with an optimal value of &#8804;0&#46;91&#46; FFR was undertaken in 93 out of 94 lesions with an inconclusive iFR and was performed in 69&#46;1&#37; of the remaining iFR-tested lesions&#46; Concordance between iFR and FFR was 87&#37; &#40;chi-square&#61;22&#46;43&#59; p&#60;0&#46;001&#41;&#46; Notwithstanding&#44; there were four out of 13 cases &#40;30&#46;7&#37;&#41; of positive iFR with negative FFR and three out of 42 &#40;7&#46;1&#37;&#41; cases of negative iFR and positive FFR&#46; This difference was significant &#40;p&#61;0&#46;026&#41;&#46; iFR had no impact on procedure time&#44; fluoroscopy time or radiation dose&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">iFR had a reasonable diagnostic performance&#46; Operators often chose to perform FFR despite conclusive iFR results&#46; iFR and FFR were highly concordant&#44; but a non-negligible proportion of lesions classified as ischemic by iFR were classified as non-ischemic by FFR&#46; iFR had no impact on procedural characteristics&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introduction and Objective"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Methods"
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          2 => array:2 [
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            "titulo" => "Results"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introdu&#231;&#227;o e objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A avalia&#231;&#227;o de les&#245;es coron&#225;rias pelo <span class="elsevierStyleItalic">instantaneous wave free ratio</span> &#40;iFR&#41; tem gerado debate&#46; Pretendeu-se analisar o desempenho diagn&#243;stico do iFR e o seu impacto na decis&#227;o de utilizar o <span class="elsevierStyleItalic">fractional flow reserve</span> &#40;FFR&#41; e nas caracter&#237;sticas do procedimento&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Registo unic&#234;ntrico de doentes submetidos a avalia&#231;&#227;o funcional de les&#245;es coron&#225;rias&#46; O desempenho do iFR foi aferido utilizando o FFR como refer&#234;ncia&#46; Valores de iFR &#60; 0&#44;86 e &#62; 0&#44;93 foram considerados positivos e negativos&#44; respetivamente&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">avaliaram-se 402 les&#245;es&#44; em 154 casos com ambas as t&#233;cnicas&#44; em 222 apenas com FFR e 26 apenas com iFR&#46; Utilizando um limiar de FFR &#8804; 0&#44;80&#44; a &#225;rea sob a curva foi de 0&#44;73 &#40;95&#37; IC 0&#44;65-0&#44;81&#41; - valor &#243;timo de iFR &#8804; 0&#44;91&#46; Efetuou-se FFR em 93 de 94 les&#245;es inconclusivas por iFR e em 69&#44;1&#37; dos restantes casos aferidos com iFR&#46; O iFR e o FFR foram concordantes em 87&#37; dos casos &#40;X<span class="elsevierStyleSup">2</span>&#61;22&#44;43&#59; p&#60;0&#44;001&#41;&#46; N&#227;o obstante&#44; verificaram-se 4 em 13 casos &#40;30&#44;7&#37;&#41; de iFR positivo e FFR negativo&#44; e 3 em 42 casos &#40;7&#44;1&#37;&#41; de iFR negativo e FFR positivo&#46; Esta diferen&#231;a foi estatisticamente significativa &#40;p&#61;0&#44;026&#41;&#46; O iFR n&#227;o teve impacto na dura&#231;&#227;o&#44; dose&#47;tempo de radia&#231;&#227;o do procedimento&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclus&#245;es</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">O desempenho diagn&#243;stico do iFR foi razo&#225;vel&#46; Os operadores habitualmente efetuaram FFR apesar de valores conclusivos de iFR&#46; Verificou-se elevada concord&#226;ncia&#44; mas com uma propor&#231;&#227;o n&#227;o negligenci&#225;vel de les&#245;es classificadas como isqu&#233;micas por iFR e n&#227;o isqu&#233;micas por FFR&#46; O iFR n&#227;o teve impacto nas caracter&#237;sticas do procedimento&#46;</p></span>"
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Nobre Menezes M&#44; Francisco AR&#44; Carrilho Ferreira P&#44; Jorge C&#44; Torres D&#44; Cardoso P&#44; et al&#46; An&#225;lise comparativa do <span class="elsevierStyleItalic">fractional flow reserve</span> &#40;FFR&#41; e do <span class="elsevierStyleItalic">instantaneous wave-free ratio</span> &#40;iFR&#41;&#58; resultados de um registo de 5 anos&#46; Rev Port Cardiol&#46; 2018&#59;37&#58;511&#8211;520&#46;</p>"
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          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Distribution of lesions according to method of functional assessment used&#46; FFR&#58; fractional flow reserve&#59; iFR&#58; instantaneous wave-free ratio&#46;</p>"
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Concordance between instantaneous wave-free ratio &#40;iFR&#41; and fractional flow reserve &#40;FFR&#41; measurements by Bland-Altman analysis&#46;</p>"
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          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Receiver operating characteristic &#40;ROC&#41; curve analysis of instantaneous wave-free ratio &#40;iFR&#41; measurements according to the two reference values of fractional flow reserve &#40;FFR&#41; &#40;&#8804;0&#46;80 and &#60;0&#46;75&#41;&#46; AUC&#58; area under the curve&#59; CI&#58; confidence interval&#46;</p>"
        ]
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        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
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          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Flowchart of concordant and discordant instantaneous wave-free ratio &#40;iFR&#41; and fractional flow reserve &#40;FFR&#41; measurements&#46;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Values are mean &#177; SD or n &#40;&#37;&#41;&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">AF&#58; atrial fibrillation&#59; CABG&#58; coronary artery bypass grafting&#59; eGFR&#58; estimated glomerular filtration rate&#59; LVEF&#58; left ventricular ejection fraction&#59; MI&#58; myocardial infarction&#59; NSTEMI&#58; non-ST-elevation myocardial infarction&#59; PCI&#58; percutaneous coronary intervention&#59; SR&#58; sinus rhythm&#59; STEMI&#58; ST-elevation myocardial infarction&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Overall&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">iFR only&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">FFR only&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">Hybrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p for iFR only vs&#46; FFR only&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p for iFR only vs&#46; hybrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col">p for FFR only vs&#46; hybrid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">9 &#40;2&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">179 &#40;54&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">138 &#40;42&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Demographic</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;0&#177;10&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#177;8&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&#46;8&#177;10&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;3&#177;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">224 &#40;68&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">127&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">History</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">271 &#40;83&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">150&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">114&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Dyslipidemia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">243 &#40;74&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">136&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;034&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">109 &#40;33&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">121 &#40;37&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">63&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Previous MI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">77 &#40;23&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Previous PCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">117 &#40;35&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Previous CABG&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13 &#40;4&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">LVEF</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Normal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">168 &#40;71&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">90&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mildly impaired&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23 &#40;9&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Moderately impaired&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29 &#40;12&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Severely impaired&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Renal dysfunction &#40;eGFR &#60;60 ml&#47;min&#47;1&#46;73 m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">72 &#40;22&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Multivessel disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">64 &#40;19&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Clinical presentation</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Stable angina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">231 &#40;70&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">132&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">91&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Unstable angina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28 &#40;8&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>STEMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>NSTEMI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61 &#40;18&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="8" align="left" valign="top"><span class="elsevierStyleItalic">Cardiac rhythm</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>SR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">304 &#40;93&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">166&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">129&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>AF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8 &#40;2&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pacing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Baseline characteristics of the study population &#40;n&#61;326&#41;&#46;</p>"
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        "etiqueta" => "Table 2"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Vessel</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Left main&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Anterior descending&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">242 &#40;60&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Circumflex&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">73 &#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Right coronary&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">71 &#40;17&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diagonal branch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;0&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Type of lesion</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">128 &#40;31&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>B1&#47;B2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">98 &#40;24&#46;4&#41;&#47;132 &#40;32&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44 &#40;10&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Degree of stenosis</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>30-49&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">41 &#40;10&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>50-69&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">271 &#40;67&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>70-89&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">88 &#40;21&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>&#8805;90&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;0&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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        "etiqueta" => "Table 3"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FFR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Decision&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Clinical presentation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Vessel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Degree of stenosis on angiography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Lesion type&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;73&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70-89&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70-89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OMT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-69&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;84&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OMT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-69&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OMT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">LAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-69&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;82&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OMT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Cx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-69&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">B1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="char" valign="top">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">0&#46;97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">OMT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">AD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50-69&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">179 &#40;54&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">138 &#40;42&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">-&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">61&#46;5&#177;30&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;4&#177;8&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;0&#177;9&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Radiation dose in mGy&#47;cm<span class="elsevierStyleSup">2</span>&#44; mean &#177; SD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">11&#46;7&#177;7&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;8&#177;8&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NS&nbsp;\t\t\t\t\t\t\n
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      "titulo" => "References"
      "seccion" => array:1 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                        0 => array:2 [
                          "etal" => true
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                            0 => "S&#46; Windecker"
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                  ]
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                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehu278"
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                        "link" => array:1 [
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                          "etal" => true
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                            0 => "B&#46; De Bruyne"
                            1 => "N&#46;H&#46;J&#46; Pijls"
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                  "contribucion" => array:1 [
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                      "titulo" => "Deferral vs&#46; performance of percutaneous coronary intervention of functionally non-significant coronary stenosis&#58; 15-year follow-up of the DEFER trial"
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                          "etal" => true
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                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehv452"
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                        "tituloSerie" => "Eur Heart J"
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                        "paginaFinal" => "3188"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26400825"
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                      "titulo" => "Impact of routine fractional flow reserve evaluation during coronary angiography on management strategy and clinical outcome"
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