Influence of fractional flow reserve on grafts patency: Systematic review and patient-level meta-analysis.
Details
State: Public
Version: Final published version
License: CC BY-NC-ND 4.0
Serval ID
serval:BIB_2890103CB40C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Influence of fractional flow reserve on grafts patency: Systematic review and patient-level meta-analysis.
Journal
Catheterization and cardiovascular interventions
ISSN
1522-726X (Electronic)
ISSN-L
1522-1946
Publication state
Published
Issued date
02/2022
Peer-reviewed
Oui
Volume
99
Number
3
Pages
730-735
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Systematic Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
To investigate the impact of invasive functional guidance for coronary artery bypass graft surgery (CABG) on graft failure.
Data on the impact of fractional flow reserve (FFR) in guiding CABG are still limited.
Systematic review and individual patient data meta-analysis were performed. Primary objective was the risk of graft failure, stratified by FFR. Risk estimates are reported as odds ratios (ORs) derived from the aggregated data using random-effects models. Individual patient data were analyzed using mixed effect model to assess relationship between FFR and graft failure. This meta-analysis is registered in PROSPERO (CRD42020180444).
Four prospective studies comprising 503 patients referred for CABG, with 1471 coronaries, assessed by FFR were included. Graft status was available for 1039 conduits at median of 12.0 [IQR 6.6; 12.0] months. Risk of graft failure was higher in vessels with preserved FFR (OR 5.74, 95% CI 1.71-19.29). Every 0.10 FFR units decrease in the coronaries was associated with 56% risk reduction of graft failure (OR 0.44, 95% CI 0.34 to 0.59). FFR cut-off to predict graft failure was 0.79.
Surgical grafting of coronaries with functionally nonsignificant stenoses was associated with higher risk of graft failure.
Data on the impact of fractional flow reserve (FFR) in guiding CABG are still limited.
Systematic review and individual patient data meta-analysis were performed. Primary objective was the risk of graft failure, stratified by FFR. Risk estimates are reported as odds ratios (ORs) derived from the aggregated data using random-effects models. Individual patient data were analyzed using mixed effect model to assess relationship between FFR and graft failure. This meta-analysis is registered in PROSPERO (CRD42020180444).
Four prospective studies comprising 503 patients referred for CABG, with 1471 coronaries, assessed by FFR were included. Graft status was available for 1039 conduits at median of 12.0 [IQR 6.6; 12.0] months. Risk of graft failure was higher in vessels with preserved FFR (OR 5.74, 95% CI 1.71-19.29). Every 0.10 FFR units decrease in the coronaries was associated with 56% risk reduction of graft failure (OR 0.44, 95% CI 0.34 to 0.59). FFR cut-off to predict graft failure was 0.79.
Surgical grafting of coronaries with functionally nonsignificant stenoses was associated with higher risk of graft failure.
Keywords
Coronary Angiography, Coronary Artery Disease/surgery, Coronary Stenosis/diagnostic imaging, Coronary Stenosis/surgery, Fractional Flow Reserve, Myocardial, Humans, Prospective Studies, Treatment Outcome, coronary artery bypass surgery, fractional flow reserve, graft patency
Pubmed
Web of science
Open Access
Yes
Create date
12/07/2021 8:44
Last modification date
25/01/2024 8:32
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