Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data.

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License: CC BY-NC 4.0
Serval ID
serval:BIB_E0D03CAB7C57
Type
Article: article from journal or magazin.
Collection
Publications
Title
Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data.
Journal
European heart journal
Author(s)
Zimmermann F.M., Omerovic E., Fournier S., Kelbæk H., Johnson N.P., Rothenbühler M., Xaplanteris P., Abdel-Wahab M., Barbato E., Høfsten D.E., Tonino PAL, Boxma-de Klerk B.M., Fearon W.F., Køber L., Smits P.C., De Bruyne B., Pijls NHJ, Jüni P., Engstrøm T.
ISSN
1522-9645 (Electronic)
ISSN-L
0195-668X
Publication state
Published
Issued date
07/01/2019
Peer-reviewed
Oui
Volume
40
Number
2
Pages
180-186
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
To assess the effect of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with contemporary drug-eluting stents on the composite of cardiac death or myocardial infarction (MI) vs. medical therapy in patients with stable coronary lesions.
We performed a systematic review and meta-analysis of individual patient data (IPD) of the three available randomized trials of contemporary FFR-guided PCI vs. medical therapy for patients with stable coronary lesions: FAME 2 (NCT01132495), DANAMI-3-PRIMULTI (NCT01960933), and Compare-Acute (NCT01399736). FAME 2 enrolled patients with stable coronary artery disease (CAD), while the other two focused on non-culprit lesions in stabilized patients after acute coronary syndrome. A total of 2400 subjects were recruited from 54 sites world-wide with 1056 randomly assigned to FFR-guided PCI and 1344 to medical therapy. The pre-specified primary outcome was a composite of cardiac death or MI. We included data from extended follow-ups for FAME 2 (up to 5.5 years follow-up) and DANAMI-3-PRIMULTI (up to 4.7 years follow-up). After a median follow-up of 35 months (interquartile range 12-60 months), a reduction in the composite of cardiac death or MI was observed with FFR-guided PCI as compared with medical therapy (hazard ratio 0.72, 95% confidence interval 0.54-0.96; P = 0.02). The difference between groups was driven by MI.
In this IPD meta-analysis of the three available randomized controlled trials to date, FFR-guided PCI resulted in a reduction of the composite of cardiac death or MI compared with medical therapy, which was driven by a decreased risk of MI.
Pubmed
Web of science
Open Access
Yes
Create date
23/01/2019 11:51
Last modification date
20/08/2019 17:05
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