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Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
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Outcomes associated with fractional flow-guided revascularization: a meta-analysis
Anthony A Bavry1, Islam Y Elgendy, John W Petersen
1North Florida/South Georgia Veterans Health System, Gainesville, Florida; Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida.
Clinical Cardiology
|July 22, 2014
Summary
Deferring treatment for non-ischemic coronary lesions is common. This meta-analysis shows deferral is safe for left main disease but associated with better outcomes in non-left main disease when ischemia is present.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Outcomes Research
Background:
- The long-term outcomes of deferring revascularization for nonischemic coronary lesions are not well-established.
- Current guidelines generally recommend deferral for lesions deemed abnormal but not causing ischemia.
Purpose of the Study:
- To evaluate the clinical outcomes of deferring revascularization in patients with coronary artery lesions.
- To compare outcomes between left main and non-left main coronary artery lesions.
Main Methods:
- A systematic meta-analysis of studies identified via PubMed search.
- Included studies reported clinical outcomes following fractional flow reserve-guided revascularization.
- Outcomes were analyzed for left main and non-left main coronary artery subgroups.
Main Results:
- 17 studies with 2975 participants were included.
- For left main disease, adverse events were similar between deferral (15.3%) and revascularization (14.3%) groups.
- For non-left main disease, deferral had significantly fewer adverse events (9.2%) compared to revascularization (18.8%) when ischemia was present.
Conclusions:
- Deferral of revascularization for left main coronary artery disease is associated with similar adverse event rates compared to revascularization.
- In non-left main coronary artery disease, deferral is linked to better outcomes when lesions are not ischemic.
