| Autor: |
Gupta, Saarik, Suresh Kumar, Gayatri, Khan, Abdur R, Ghafghazi, Shahab |
| Zdroj: |
Circulation (Ovid); November 2019, Vol. 140 Issue: Supplement 1 pA12814-A12814, 1p |
| Abstrakt: |
Introduction:Pressure-wire fractional flow reserve (FFR) remains the gold standard in detection of hemodynamically significant coronary lesions. Noninvasive angiography derived FFR (vFFR) without the use of a pressure wire has shown significant promise. This systematic review and meta-analysis aims to evaluate the performance of vFFR in comparison to pressure-wire FFR.Hypothesis:vFFR is comparable to pressure-wire FFR in detection of clinically significant coronary lesions.Methods:A systematic review and meta-analysis of studies assessing vFFR compared to pressure-wire FFR was conducted. A total of 258 studies were initially selected from EMBASE, Cochrane, and PubMed based on a keyword search generated by a librarian. The studies were reviewed and data extracted by two authors independently with a third author to settle disagreements. Data was analyzed using RevMan 5.3 and STATA.Results:Extraction yielded 4441 lesions from 3472 patients in 23 studies. The primary outcomes were pooled sensitivity, specificity, and diagnostic odds ratio which were 86.7% (95% CI 0.822-0.900), 90.7% (95% CI 0.879-0.930), and 63.4 (95% CI 40.1-100.5), respectively. The positive likelihood ratio was 9.36 (95% CI 7.11-12.3) and negative likelihood ratio 0.148 (95% CI 0.110-0.198). The area under the curve of the SROC plot was 0.95 (95% CI 0.93-0.97).Conclusions:This meta-analysis suggests that noninvasive angiographically-derived vFFR has excellent discrimination in the detection of hemodynamically significant coronary lesions, comparable to gold standard. A randomized controlled trial powered for clinical outcomes is the next step forward. |
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