Fractional flow reserve use in coronary artery revascularization: A systematic review and meta-analysis.

Fecha de publicación: 18/08/2023 Fecha Ahead of Print: 03/07/2023

Autores de IIS La Fe

• Jorge Sanz Sánchez

  Autor

• José Luis Díez Gil

  Autor

Participantes ajenos a IIS La Fe

• Farjat Pasos, Julio I
• Martinez Sole, Julia
• Hussain, Bilal
• Kumar, Sant
• Garg, Mohil
• Chiarito, Mauro
• Teira Calderon, Andrea
• Sorolla-Romero, Jose A.
• Echavarria Pinto, Mauro
• Shin, Eun-Seok
• Waksman, Ron
• van de Hoef, Tim P.
• Garcia-Garcia, Hector M.

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

  

  Investigador Principal

  Esther Roselló Lletí

Abstract

Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is recommended in revascularization guidelines for intermediate lesions. However, recent studies comparing FFR-guided PCI with non-physiology-guided revascularization have reported conflicting results. PubMed and Embase were searched for studies comparing FFR-guided PCI with non-physiology-guided revascularization strategies (angiography-guided, intracoronary imaging-guided, coronary artery bypass grafting). Data were pooled by meta-analysis using random-effects model. 26 studies enrolling 78,897 patients were included. FFR-guided PCI as compared to non-physiology-guided coronary revascularization had lower risk of all-cause mortality (odds ratio [OR] 0.79 95% confidence interval [CI] 0.64-0.99, I2= 53%) and myocardial infarction (MI) (OR 0.74 95% CI 0.59-0.93, I2= 44.7%). However, no differences between groups were found in terms of major adverse cardiac events (MACEs) (OR 0.86 95% CI 0.72-1.03, I2= 72.3%) and repeat revascularization (OR 1 95% CI 0.82-1.20, I2= 43.2%). Among patients with coronary artery disease (CAD), FFR-guided PCI as compared to non-physiology-guided revascularization was associated with a lower risk of all-cause mortality and MI.

© 2023 The Authors.

Keywords

• Cardiovascular medicine; Pathology; Surgery