FFR-guided PCI provides significant value, new meta-analysis confirms.

“Our findings show that with an FFR-guided PCI strategy in patients with multivessel CAD, 40% of lesions that are classified as angiographically significant can be reclassified as not physiologically significant,” wrote first author Connor Jack Matthews, MBChB, BSc, of Leeds. General Infirmary in the UK, and colleagues.

The study’s composite endpoint was death, nonfatal MI or repeat revascularization after one year. This was seen in 10.7% of FFR-guided PCI patients and 11.8% of angiography-guided PCI patients, a small enough difference that it was not found to be clinically significant. The one-year rates of all-cause mortality, nonfatal MI and repeat revascularization were all also comparable when observing each one separately.

The team did note that their work had certain limitations. Follow-up was limited to just one year, for example, and researchers were unable to carry out a more in-depth, patient-level analysis due to the way they designed their study.

Matthews et al. concluded that FFR-guided PCI is a “helpful” resource that could make a considerable impact on patient care.

“Up to 40% of angiographically significant lesions can be safely deferred; this would reduce procedure times, contrast agent dose, and radiation dose for patients and would improve resource utilization in clinical practice,” they wrote.


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