Key result
FFR-recommended percutaneous coronary intervention was associated with significantly higher major adverse cardiac events (OR 1.34) compared to FFR-deferred revascularization in patients with stable coronary artery disease.
Why the study?
Does FFR-recommended PCI reduce long-term MACEs compared to FFR-deferred PCI in patients with stable coronary artery disease?
Meta-Analysis (n=1,753)
Does FFR-recommended PCI reduce long-term MACEs compared to FFR-deferred PCI in patients with stable coronary artery disease?
Odds Ratio: 1.34 (95% CI 1.05–1.72)
p-value: p=0.02
In patients with stable CAD, those with FFR-recommended PCI had higher rates of MACEs and MI compared to those with FFR-deferred PCI, reflecting the higher baseline risk of patients with hemodynamically significant lesions.
FFR-recommended PCI linked to higher MACE than deferral; confirms FFR stratifies risk in stable CAD without proving intervention benefit.
BACKGROUND: Nowadays, fraction flow reserve (FFR) is being discussed in every percutaneous coronary intervention (PCI) capable hospitals. Owing to recent development in the medical field, FFR-guided PCI should be able to find a place in Interventional Cardiology. At present, the importance of FFR to stratify patients who require PCI has seldom systematically been investigated. In this analysis, we aimed to compare the major adverse cardiac events (MACEs) mainly in patients with stable coronary artery disease (CAD) to whom PCI was recommended and deferred respectively based on the FFR value. METHODS: Electronic databases were searched for studies comparing FFR-recommended versus FFR-deferred coronary stenting. Long-term MACEs, mortality, and myocardial infarction (MI) were considered as the clinical endpoints in this analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated and the analyses were carried out by the latest version of the RevMan software. RESULTS: A total number of 1753 patients (670 patients were revascularized, whereas 1083 patients were deferred from revascularization based on the FFR value) were analyzed. Current results showed MACEs and MI were significantly higher in the FFR-recommended PCI group with OR 1.34 (95% CI: 1.05-1.72; P = .02) and OR 1.73 (95% CI: 1.19-2.51; P = .004, I = 0%), respectively. However, mortality was similarly manifested with OR 1.23 (95% CI: 0.92-1.63; P = .16, I = 0%). CONCLUSION: Significantly higher MACEs were observed in patients to whom PCI was recommended compared to those patients who were deferred from undergoing PCI based on the FFR values. Therefore, FFR might indeed be an important decision-making procedural tool, which should be used to stratify stable CAD patients with an advanced disease and who are qualified candidates for PCI. Further research should confirm this hypothesis.
No takes yet. Share an insight, caveat, or question.
Bundhun et al. (2017) conducted a meta-analysis in Stable coronary artery disease (n=1,753). FFR-recommended percutaneous coronary intervention vs. FFR-deferred revascularization was evaluated on Major adverse cardiac events (MACEs) (OR 1.34, 95% CI 1.05-1.72, p=0.02). FFR-recommended percutaneous coronary intervention was associated with significantly higher major adverse cardiac events (OR 1.34) compared to FFR-deferred revascularization in patients with stable coronary artery disease.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: