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Clinical value of post–percutaneous coronary intervention fractional flow reserve value: A systematic review and meta‐analysis

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Background Fractional flow reserve (FFR) prior to percutaneous coronary intervention (PCI) is useful to guide treatment. Whether post‐PCI FFR assessment might have clinical impact is controversial. The aim of this… Click to show full abstract

Background Fractional flow reserve (FFR) prior to percutaneous coronary intervention (PCI) is useful to guide treatment. Whether post‐PCI FFR assessment might have clinical impact is controversial. The aim of this study is to evaluate the range of post‐PCI FFR values and analyze the relationship between post‐PCI FFR and clinical outcomes. Methods We systematically searched the PubMed, EMBASE, and Cochrane Library databases with cross‐referencing of articles reporting post‐PCI FFR and correlating post‐PCI FFR values and clinical outcomes. The outcomes of interest were the immediate post‐PCI FFR values and the correlations between post‐PCI FFR and the incidence of repeat intervention and major adverse cardiac events (MACE). Results From 1995 to 2015, a total of 105 studies (n = 7470) were included, with 46 studies reporting post‐PCI FFR and 59 studies evaluating relationship between post‐PCI and clinical outcomes up to 30 months after PCI. Overall, post‐PCI FFR values demonstrated a normal distribution with a mean value of 0.90 ± 0.04. There was a positive correlation between the percentage of stent use and post‐PCI FFR (P < .0001). Meta‐regression analysis indicated that higher post‐PCI FFR values were associated with reduced rates of repeat intervention (P < .0001) and MACE (P = .0013). A post‐PCI FFR ≥0.90 was associated with significantly lower risk of repeat PCI (odds ratio 0.43, 95% CI 0.34‐0.56, P < .0001) and MACE (odds ratio 0.71, 95% CI 0.59‐0.85, P = .0003). Conclusions FFR measurement after PCI was associated with prognostic significance. Further investigation is required to assess the role of post‐PCI FFR and validate cutoff values in contemporary clinical practice.

Keywords: post pci; value; post; pci; pci ffr

Journal Title: American Heart Journal
Year Published: 2017

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