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Prognostic Implications of Fractional Flow Reserve after Coronary Stenting: A Systematic Review and Meta-analysis

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dc.contributor.authorHwang, D-
dc.contributor.authorKoo, BK-
dc.contributor.authorZhang, J-
dc.contributor.authorPark, J-
dc.contributor.authorYang, S-
dc.contributor.authorKim, M-
dc.contributor.authorYun, JP-
dc.contributor.authorLee, JM-
dc.contributor.authorNam, CW-
dc.contributor.authorShin, ES-
dc.contributor.authorDoh, JH-
dc.contributor.authorChen, SL-
dc.contributor.authorKakuta, T-
dc.contributor.authorToth, GG-
dc.contributor.authorPiroth, Z-
dc.contributor.authorJohnson, NP-
dc.contributor.authorPijls, NHJ-
dc.contributor.authorHakeem, A-
dc.contributor.authorUretsky, BF-
dc.contributor.authorHokama, Y-
dc.contributor.authorTanaka, N-
dc.contributor.authorLim, HS-
dc.contributor.authorIto, T-
dc.contributor.authorMatsuo, A-
dc.contributor.authorAzzalini, L-
dc.contributor.authorLeesar, MA-
dc.contributor.authorNeleman, T-
dc.contributor.authorvan Mieghem, NM-
dc.contributor.authorDiletti, R-
dc.contributor.authorDaemen, J-
dc.contributor.authorCollison, D-
dc.contributor.authorCollet, C-
dc.contributor.authorDe Bruyne, B-
dc.date.accessioned2023-02-13T06:23:26Z-
dc.date.available2023-02-13T06:23:26Z-
dc.date.issued2022-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/24578-
dc.description.abstractIMPORTANCE: Fractional flow reserve (FFR) after percutaneous coronary intervention (PCI) is generally considered to reflect residual disease. Yet the clinical relevance of post-PCI FFR after drug-eluting stent (DES) implantation remains unclear. OBJECTIVE: To evaluate the clinical relevance of post-PCI FFR measurement after DES implantation. DATA SOURCES: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched for relevant published articles from inception to June 18, 2022. STUDY SELECTION: Published articles that reported post-PCI FFR after DES implantation and its association with clinical outcomes were included. DATA EXTRACTION AND SYNTHESIS: Patient-level data were collected from the corresponding authors of 17 cohorts using a standardized spreadsheet. Meta-estimates for primary and secondary outcomes were analyzed per patient and using mixed-effects Cox proportional hazard regression with registry identifiers included as a random effect. All processes followed the Preferred Reporting Items for Systematic Review and Meta-analysis of Individual Participant Data. MAIN OUTCOMES AND MEASURES: The primary outcome was target vessel failure (TVF) at 2 years, a composite of cardiac death, target vessel myocardial infarction (TVMI), and target vessel revascularization (TVR). The secondary outcome was a composite of cardiac death or TVMI at 2 years. RESULTS: Of 2268 articles identified, 29 studies met selection criteria. Of these, 28 articles from 17 cohorts provided data, including a total of 5277 patients with 5869 vessels who underwent FFR measurement after DES implantation. Mean (SD) age was 64.4 (10.1) years and 4141 patients (78.5%) were men. Median (IQR) post-PCI FFR was 0.89 (0.84-0.94) and 690 vessels (11.8%) had a post-PCI FFR of 0.80 or below. The cumulative incidence of TVF was 340 patients (7.2%), with cardiac death or TVMI occurring in 111 patients (2.4%) at 2 years. Lower post-PCI FFR significantly increased the risk of TVF (adjusted hazard ratio [HR] per 0.01 FFR decrease, 1.04; 95% CI, 1.02-1.05; P < .001). The risk of cardiac death or MI also increased inversely with post-PCI FFR (adjusted HR, 1.03; 95% CI, 1.00-1.07, P = .049). These associations were consistent regardless of age, sex, the presence of hypertension or diabetes, and clinical diagnosis. CONCLUSIONS AND RELEVANCE: Reduced FFR after DES implantation was common and associated with the risks of TVF and of cardiac death or TVMI. These results indicate the prognostic value of post-PCI physiologic assessment after DES implantation.-
dc.language.isoen-
dc.subject.MESHCoronary Angiography-
dc.subject.MESHDeath-
dc.subject.MESHDrug-Eluting Stents-
dc.subject.MESHFemale-
dc.subject.MESHFractional Flow Reserve, Myocardial-
dc.subject.MESHHumans-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMyocardial Infarction-
dc.subject.MESHPercutaneous Coronary Intervention-
dc.subject.MESHPrognosis-
dc.subject.MESHTreatment Outcome-
dc.titlePrognostic Implications of Fractional Flow Reserve after Coronary Stenting: A Systematic Review and Meta-analysis-
dc.typeArticle-
dc.identifier.pmid36136329-
dc.identifier.urlhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9500557-
dc.contributor.affiliatedAuthorLim, HS-
dc.type.localJournal Papers-
dc.identifier.doi10.1001/jamanetworkopen.2022.32842-
dc.citation.titleJAMA network open-
dc.citation.volume5-
dc.citation.number9-
dc.citation.date2022-
dc.citation.startPageE2232842-
dc.citation.endPageE2232842-
dc.identifier.bibliographicCitationJAMA network open, 5(9). : E2232842-E2232842, 2022-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn2574-3805-
dc.relation.journalidJ025743805-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
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