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LONG TERM OUTCOMES FOLLOWING FRACTIONAL FLOW RESERVE GUIDED TREATMENT OF INDETERMINATE LEFT MAIN CORONARY ARTERY DISEASE: A META-ANALYSIS OF PROSPECTIVE COHORT STUDIES
A1912 JACC April 1, 2014 Volume 63, Issue 12
TCT@ACC-i2: The Interventional Learning Pathway Long Term Outcomes Following Fractional Flow Reserve Guided Treatment of Indeterminate Left Main Coronary Artery Disease: A Meta-Analysis of Prospective Cohort Studies Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 p.m.
Session Title: Left Main, Multivessel, and Bifurcation PCI Abstract Category: 40. TCT@ACC-i2: Coronary Intervention: Lmain, Multivessel, Bifurcation Presentation Number: 2112-312 Authors: Auras Ravi Atreya, Jaya Mallidi, James Cook, Jane Garb, Allen Jeremias, Lloyd Klein, Amir Lotfi, Baystate Medical Center/ Tufts University School of Medicine, Springfield, MA, USA Background: Prospective studies evaluating the use of Fractional Flow Reserve (FFR) for clinical decision-making in indeterminate unprotected left main coronary artery (ULMCA) stenosis have been limited by small sample size. We performed a pooled meta-analysis of all available studies to define the long term outcomes in these patients. Methods: Six prospective cohort studies involving 525 patients met the inclusion criteria. Patients underwent revascularization (revasc group) or medical therapy (deferred group) based on an FFR cut point of 0.80. The primary outcomes were all-cause mortality and major event free survival (defined as death, MI and revascularization). A pooled effect size for each group and odds ratios were calculated using a fixed effects model. Results: Based on the FFR results, revascularization was undertaken in 217 patients (41%) and deferred in 308 (58%) of the patients (Figure 1). The overall survival in the deferred group was 96% and was 89% in the revasc group. There was a trend towards overall improved survival in the deferred group (OR: 0.51, 95% CI: 0.25 - 1.00,p=0.05) and a non-statistically significant trend towards improved event-free survival in the revasc group (OR: 1.5, 95% CI: 0.9 - 2.4, p=0.08) Conclusion: For patients with indeterminate ULMCA stenosis, deferral of revascularization based on assessment by FFR appears to be safe.
TCT@ACC-i2: The Interventional Learning Pathway Long Term Outcomes Following Fractional Flow Reserve Guided Treatment of Indeterminate Left Main Coronary Artery Disease: A Meta-Analysis of Prospective Cohort Studies Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 p.m.
Session Title: Left Main, Multivessel, and Bifurcation PCI Abstract Category: 40. TCT@ACC-i2: Coronary Intervention: Lmain, Multivessel, Bifurcation Presentation Number: 2112-312 Authors: Auras Ravi Atreya, Jaya Mallidi, James Cook, Jane Garb, Allen Jeremias, Lloyd Klein, Amir Lotfi, Baystate Medical Center/ Tufts University School of Medicine, Springfield, MA, USA Background: Prospective studies evaluating the use of Fractional Flow Reserve (FFR) for clinical decision-making in indeterminate unprotected left main coronary artery (ULMCA) stenosis have been limited by small sample size. We performed a pooled meta-analysis of all available studies to define the long term outcomes in these patients. Methods: Six prospective cohort studies involving 525 patients met the inclusion criteria. Patients underwent revascularization (revasc group) or medical therapy (deferred group) based on an FFR cut point of 0.80. The primary outcomes were all-cause mortality and major event free survival (defined as death, MI and revascularization). A pooled effect size for each group and odds ratios were calculated using a fixed effects model. Results: Based on the FFR results, revascularization was undertaken in 217 patients (41%) and deferred in 308 (58%) of the patients (Figure 1). The overall survival in the deferred group was 96% and was 89% in the revasc group. There was a trend towards overall improved survival in the deferred group (OR: 0.51, 95% CI: 0.25 - 1.00,p=0.05) and a non-statistically significant trend towards improved event-free survival in the revasc group (OR: 1.5, 95% CI: 0.9 - 2.4, p=0.08) Conclusion: For patients with indeterminate ULMCA stenosis, deferral of revascularization based on assessment by FFR appears to be safe.