Abstract:
:The present study aimed to compare the clinical outcome of patients with coronary artery disease (CAD) who underwent a revascularization using conventional coronary angiography or a physiologically guided revascularization with Fractional Flow Reserve (FFR). Furthermore, outcomes in FFR guided percutaneous coronary intervention (PCI) and instantaneous wave-free ratio (iFR) guided PCI were compared. The analysis was performed for reported outcomes at a 1-year follow-up. After searching PubMed, EMBASE, and Web of Science for suitable publications, a total of 15,880 subjects were included. Comparing angiography guided and FFR guided PCI showed no significant difference in major adverse cardiac events [odds ratio (OR), 0.78; 95% confidence interval (CI), 0.59-1.04; P=0.09; I2=73%], death from any cause (OR, 0.74; 95% CI, 0.46-1.18; P=0.20; I2=74%), myocardial infarction (OR, 0.93; 95% CI, 0.81-1.07; P=0.31; I2=0%) or unplanned revascularization (OR, 0.71; 95% CI, 0.41-1.23; P=0.22; I2=79%). In addition, no significant difference could be found between iFR and FFR guided PCI for major adverse cardiac events (OR, 0.97; 95% CI; 0.76-1.23; P=0.81; I2=0%), death from any cause (OR, 0.66; 95% CI, 0.40-1.11; P=0.12; I2=0%), myocardial infarction (OR, 0.83; 95% CI, 0.56-1.24; P=0.37) or unplanned revascularization (OR, 1.16; 95% CI, 0.85-1.58; P=0.34; I2=16%). Overall, there was a tendency towards better outcomes of FFR in all four clinical endpoints compared with angiography guiding of PCI, and furthermore iFR showed no significant inferiority when compared to FFR in said clinical endpoints. When conducting a network meta-analysis, the results confirmed a non-inferiority of iFR compared to angiography guided revascularization.
journal_name
Exp Ther Medjournal_title
Experimental and therapeutic medicineauthors
Baumann S,Mueller KSE,Hetjens S,Eder F,Schaefer AC,Becher T,Borggrefe M,Akin I,Loßnitzer Ddoi
10.3892/etm.2019.7156subject
Has Abstractpub_date
2019-03-01 00:00:00pages
1939-1951issue
3eissn
1792-0981issn
1792-1015pii
ETM-0-0-7156journal_volume
17pub_type
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