Influence of fractional flow reserve on grafts patency: Systematic review and patient-level meta-analysis.

Autor: G Toth G; Division of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria., Collet C; Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium., Langhoff Thuesen A; Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark.; Department of Cardiology, Odense University Hospital, Odense, Denmark., Mizukami T; Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.; Clinical Research Institute for Clinical Pharmacology and Therapeutics, Showa University, Tokyo, Japan., Casselman F; Departement of Cardiovascular and Thoracic Surgery, OLV Hospital Aalst, Aalst, Belgium., Riber LP; Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark., Van Praet F; Departement of Cardiovascular and Thoracic Surgery, OLV Hospital Aalst, Aalst, Belgium., Junker A; Department of Cardiology, Odense University Hospital, Odense, Denmark., Nagumo S; Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.; Division of Cardiology, Department of Internal medicine, Showa University Fujigaoka Hospital, Kanagawa, Japan., De Bruyne B; Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.; Department of Cardiology, Universtiy Hospital Center Lausanne, Lausanne, Switzerland., Okkels Jensen L; Department of Cardiology, Odense University Hospital, Odense, Denmark., Barbato E; Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.; Department of Advanced Biomedical Sciences, University Federico II, Naples, Italy.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2022 Feb; Vol. 99 (3), pp. 730-735. Date of Electronic Publication: 2021 Jul 07.
DOI: 10.1002/ccd.29864
Abstrakt: Objective: To investigate the impact of invasive functional guidance for coronary artery bypass graft surgery (CABG) on graft failure.
Background: Data on the impact of fractional flow reserve (FFR) in guiding CABG are still limited.
Methods: 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).
Results: 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.
Conclusion: Surgical grafting of coronaries with functionally nonsignificant stenoses was associated with higher risk of graft failure.
(© 2021 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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