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http://hdl.handle.net/10773/24655
Title: | Fractional flow reserve-guided strategy in acute coronary syndrome. a systematic review and meta-analysis |
Author: | Martins, José Luís Afreixo, Vera Santos, José Gonçalves, Lino |
Keywords: | Acute Coronary Syndrome/physiopathology Percutaneous Coronary Intervention/methods Coronary Angiography/ methods Fractional Flow Reserve Myocardial/physiology Microvessels Vascular Resistance Reproducibility of Results |
Issue Date: | Oct-2018 |
Publisher: | Sociedade Brasileira de Cardiologia |
Abstract: | Background: There are limited data on the prognosis of deferral of lesion treatment in patients with acute coronary syndrome (ACS) based on fractional flow reserve (FFR). Objectives: To provide a systematic review of the current evidence on the prognosis of deferred lesions in ACS patients compared with deferred lesions in non-ACS patients, on the basis of FFR. Methods: We searched Medline, EMBASE, and the Cochrane Library for studies published between January 2000 and September 2017 that compared prognosis of deferred revascularization of lesions on the basis of FFR in ACS patients compared with non-ACS patients. We conducted a pooled relative risk meta-analysis of four primary outcomes: mortality, cardiovascular (CV) mortality, myocardial infarction (MI) and target-vessel revascularization (TVR). Results: We identified 7 studies that included a total of 5,107 patients. A pooled meta-analysis showed no significant difference in mortality (relative risk [RR] = 1.44; 95% CI, 0.9–2.4), CV mortality (RR = 1.29; 95% CI = 0.4–4.3) and TVR (RR = 1.46; 95% CI = 0.9–2.3) after deferral of revascularization based on FFR between ACS and non-ACS patients. Such deferral was associated with significant additional risk of MI (RR = 1.83; 95% CI = 1.4–2.4) in ACS patients. Conclusion: The prognostic value of FFR in ACS setting is not as good as in stable patients. The results demonstrate an increased risk of MI but not of mortality, CV mortality, and TVR in ACS patients. |
Peer review: | yes |
URI: | http://hdl.handle.net/10773/24655 |
DOI: | 10.5935/abc.20180170 |
ISSN: | 0066-782X |
Appears in Collections: | CIDMA - Artigos PSG - Artigos |
Files in This Item:
File | Description | Size | Format | |
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Martins2018b.pdf | 343.82 kB | Adobe PDF | View/Open |
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