4.7 Review

Fractional Flow Reserve versus Angiography-Guided Management of Coronary Artery Disease: A Meta-Analysis of Contemporary Randomised Controlled Trials

期刊

JOURNAL OF CLINICAL MEDICINE
卷 11, 期 23, 页码 -

出版社

MDPI
DOI: 10.3390/jcm11237092

关键词

fractional flow reserve; angiography; coronary artery disease; percutaneous coronary intervention; coronary artery bypass graft surgery

向作者/读者索取更多资源

This study compared the efficacy and safety of FFR-guided versus angiography-guided management strategies in patients with obstructive CAD. The results showed no difference in outcomes such as all-cause mortality, MI, and unplanned revascularisation, but an FFR-guided strategy led to significantly fewer patients needing revascularisation.
Background and Aims: Randomised controlled trials (RCTs) comparing outcomes after fractional flow reserve (FFR)-guided versus angiography-guided management for obstructive coronary artery disease (CAD) have produced conflicting results. We investigated the efficacy and safety of an FFR-guided versus angiography-guided management strategy among patients with obstructive CAD. Methods: A systematic electronic search of the major databases was performed from inception to September 2022. We included studies of patients presenting with angina or myocardial infarction (MI), managed with medications, percutaneous coronary intervention, or bypass graft surgery. A meta-analysis was performed by pooling the risk ratio (RR) using a random-effects model. The endpoints of interest were all-cause mortality, MI and unplanned revascularisation. Results: Eight RCTs, with outcome data from 5077 patients, were included. The weighted mean follow up was 22 months. When FFR-guided management was compared to angiography-guided management, there was no difference in all-cause mortality [3.5% vs. 3.7%, RR: 0.99 (95% confidence interval (CI) 0.62-1.60), p = 0.98, heterogeneity (I-2) 43%], MI [5.3% vs. 5.9%, RR: 0.93 (95%CI 0.66-1.32), p = 0.69, I-2 42%], or unplanned revascularisation [7.4% vs. 7.9%, RR: 0.92 (95%CI 0.76-1.11), p = 0.37, I-2 0%]. However, the number patients undergoing planned revascularisation by either stent or surgery was significantly lower with an FFR-guided strategy [weighted mean difference: 14 (95% CI 3 to 25)%, p =< 0.001]. Conclusion: In patients with obstructive CAD, an FFR-guided management strategy did not impact on all-cause mortality, MI and unplanned revascularisation, when compared to an angiography-guided management strategy, but led to up to a quarter less patients needing revascularisation.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据