OUTCOMES OF DEFERRED ACUTE CORONARY SYNDROME LESIONS BASED ON NON-ISCHEMIC FRACTIONAL FLOW RESERVE AND INSTANTANEOUS WAVE-FREE RATIO: A META-ANALYSIS

2019 ◽  
Vol 73 (9) ◽  
pp. 1221
Author(s):  
Salik Nazir ◽  
Saroj Lohani ◽  
Roman Marchenko
Keyword(s):  
Acute Coronary Syndrome ◽  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Flow Reserve

scholarly journals Fractional flow reserve in acute coronary syndrome: a meta-analysis and systematic review

Open Heart ◽  
2019 ◽  
Vol 6 (1) ◽  
pp. e000934 ◽  
Author(s):  
Kevin P Liou ◽  
Sze-Yuan M Ooi ◽  
Stephen P Hoole ◽  
Nick E J West
Keyword(s):  
Acute Coronary Syndrome ◽  
Fractional Flow Reserve ◽  
Meta Analysis ◽  
Major Adverse Cardiovascular Events ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Strong Trend ◽  
Flow Reserve ◽  
All Cause Mortality

BackgroundThe utility of fractional flow reserve (FFR) to guide revascularisation in the management of acute coronary syndrome (ACS) remains unclear.ObjectiveThis study aims to compare the clinical outcomes of patients following FFR-guided revascularisation for either ACS or stable angina (SA) and in particular focuses on the outcome of those with deferred revascularisation after FFR.MethodsA meta-analysis of existing literature was performed. Outcomes including the rate of major adverse cardiovascular events (MACE), recurrent myocardial infarction (MI), mortality and unplanned revascularisation were analysed.ResultsA review of 937 records yielded 9 studies comparing 5457 patients, which were included in the analyses. Patients with ACS had a higher rate of recurrent MI (OR 1.81, p=0.02) and a strong trend towards more MACE and all-cause mortality compared with patients with SA when treated by an FFR-guided revascularisation strategy. Deferral of invasive therapy on the basis of FFR led to a higher rate of MACE (17.6% vs 7.3 %; p=0.004), recurrent MI (5.3% vs 1.5%, p=0.001) and target vessel revascularisation (16.4% vs 5.6 %; p=0.02) in patients with ACS, and a strong trend towards a higher cardiovascular mortality at follow-up when compared with patients with SA.ConclusionThe event rate in patients with ACS is much higher than SA despite following an FFR-guided revascularisation strategy. Deferring revascularisation does not appear to be as safe for ACS as it is for SA using contemporary FFR cut-offs validated in SA. Refinement of the therapeutic strategy for patients with ACS with multivessel disease is needed to redress the balance.

Outcome of coronary lesions with deferred revascularization due to negative fractional flow reserve in subjects with acute coronary syndrome

2017 ◽  
Vol 230 ◽  
pp. 335-338 ◽  
Author(s):  
Andrea Picchi ◽  
Antonio Maria Leone ◽  
Filippo Zilio ◽  
Enrico Cerrato ◽  
Fabrizio D'Ascenzo ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Fractional Flow Reserve ◽  
Fractional Flow ◽  
Coronary Syndrome ◽  
Flow Reserve ◽  
Coronary Lesions
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