Document Detail

Meta-Analysis of Deferral Versus Performance of Coronary Intervention Based on Coronary Pressure-Derived Fractional Flow Reserve.
MedLine Citation:
PMID:  25482682     Owner:  NLM     Status:  Publisher    
Fractional flow reserve (FFR) has been proposed as the gold standard to assess functional severity of coronary artery stenosis and to stratify which lesions should be subjected to intervention (percutaneous coronary intervention [PCI]). A systematic review was performed in MEDLINE and EMBASE including studies indexed until November 2013 that used FFR for deferral or performance of PCI. Outcomes of interest were death, acute myocardial infarction (AMI), and new revascularization (RV). Nineteen studies were included, totaling 3,097 patients (3,796 lesions). Mean follow-up was 21.2 months. In indirect comparisons, FFR-PCI and FFR-defer groups had similar death (2.2% vs 2.0%, respectively, p = 0.86) and AMI rates (1.9% vs 1.9%, respectively, p = 1.00). RV rates were higher in the FFR-PCI group (14.0% vs 4.4%, p = 0.002). Direct comparisons (2-arm trials) also showed no differences in death (odds ratio [OR] 1.86 [95% CI 0.81 to 4.27], I(2) = 11.5, p = 0.14) and AMI rates (OR 0.75 [95% CI 0.21 to 2.69], I(2) = 47.1, p = 0.66); RV rates were again higher in the FFR-PCI (OR 3.10 [95% CI 1.25 to 7.70], I(2) = 72.2, p = 0.015). Meta-regression suggests influence of male gender on RV rates (β = 0.058, p = 0.026). In conclusion, deferral of PCI based on FFR is a safe strategy. Considerable heterogeneity was observed, however.
Bruno R Nascimento; Ana Flávia L Belfort; Fernando Augusto C Macedo; Fernando M Sant'Anna; Gabriel T R Pereira; Marco A Costa; Antonio L P Ribeiro
Publication Detail:
Type:  REVIEW     Date:  2014-11-13
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 Nov 
Date Detail:
Created Date:  2014-12-8     Completed Date:  -     Revised Date:  2014-12-9    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
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