100.72 FFR-Guided Revascularization Versus Non-FFR-Guided Partial or Complete Revascularization in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis
Recommended Citation
Sukhon F, Jabri A, Al-Abdouh A, Alameh A, Khader S, Villablanca P, AlQarqaz M. 100.72 FFR-Guided Revascularization Versus Non-FFR-Guided Partial or Complete Revascularization in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis. JACC Cardiovasc Interv 2024; 17(4):S22.
Document Type
Conference Proceeding
Publication Date
2-1-2024
Publication Title
JACC Cardiovasc Interv
Abstract
Background: Following revascularization of the infarct related artery (IRA) in acute myocardial infarction (MI), the utility of Fractional Flow Reserve (FFR)-guided percutaneous coronary intervention (PCI) of angiographically severe non-IRAs is controversial. We performed a meta-analysis of all clinical trials involving this clinical question. Methods: We conducted a systematic review and meta-analysis including all available trials that looked at FFR-guided complete revascularization versus IRA-only revascularization or complete revascularization without FFR use. Primary outcomes were major adverse cardiac events (MACE), cardiovascular death, MI, or repeat revascularization. Secondary outcomes were death of all causes, major bleed, stent thrombosis, and stroke risk. Results: Six RCTs were included comprising a total of 2597 patients treated with IRA revascularization or complete revascularization without FFR use vs 2314 patients treated with FFR-guided complete revascularization. Compared with non-FFR use, FFR-guided PCI was significantly favored in terms of MACE (relative risk [RR] 1.65; 95% CI 1.04 - 2.63 p=0.04) and repeat revascularization (relative risk [RR] 1.92; 95% CI 1.18 - 3.11 p=0.02). There was, however, no difference in cardiovascular death (relative risk [RR] 1.67; 95% CI 0.98 - 2.85 p=0.06), MI (relative risk [RR] 1.43; 95% CI 0.78 - 2.61 p=0.19), death from any cause (relative risk [RR] 1.33; 95% CI 0.87 - 2.02 p=0.14), major bleed (relative risk [RR] 1.35; 95% CI 0.21- 8.49 p=0.56), stent thrombosis (relative risk [RR] 1.11; 95% CI 0.52 - 2.38 p=0.72), or stroke (relative risk [RR] 0.62 95% CI 0.26 - 1.44 p=0.19). Conclusion: Our meta-analysis shows that FFR-guided complete revascularization of non-IRAs at the time of MI has a significant benefit in lowering the risk of MACE and repeat revascularization. [Formula presented]
Volume
17
Issue
4
First Page
S22
