Meta-analysis Of Fractional Flow Reserve Versus Angiography For Guiding Percutaneous Intervention

Objective:This study aimed at exploring the long-term clinical outcomes of fractional flow reserve (FFR) guided percutaneous intervention (PCI) versus traditional coronary angiography (CAG) guided PCI.Methods:A meta-analysis was conducted to compare the prognosis of two different PCI strategies:FFR guided PCI and CAG guided PCI. Randomized controlled trails (RCTs)as well as real-world studies were included in this meta-analysis. Primary endpoint of this study was major adverse cardiac events (MACE). Secondary endpoints consisted of death, myocardial infarction (MI), repeat revascularisation and death or myocardial infarction.Results:This meta-analysis included7studies involving10503patients. Two of these studies were RCTs and5of them are observational studies. Absolute risk of MACE for FFR-guided PCI group was51.9%, while in CAG-guided PCI group it was51.9%. Absolute risks of death, myocardial infarction, repeat revascularisation, death or MI in both groups respectively are5.8%vs13.6%,20.8%vs31.8%,15.4%vs35.0%and 15.4%vs35.0%. This study demonstrated that MACE (RR:0.73;95%CI:0.53-0.83; p=0.001), MI (RR:0.52;95%CI:0.44-0.62; p<0.00001=,repeat revascularisation (RR:0.89;95%CI:0.82-0.96; p=0.004) and death or MI(RR:0.63;95%CI:0.57-0.69; p<0.00001=were significantly reduced in FFR-guided PCI group.Conclusion:FFR-guided PCI is associated with superior long-term clinical outcomes compared with traditional CAG-guided PCI. The results from real-world studies are in line with the RCTs. In clinical scenarios, PCI should be performed according to functional status of coronary vessels.