A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention.
<h4>Background</h4>Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography-guided PCI in randomized controlled studies. However, real-world data on the use and outcomes of FFR-guided PCI remain limited. Thus, we investiga...
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2021-01-01
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| author | Christopher C Y Wong Austin C C Ng Cuneyt Ada Vincent Chow William F Fearon Martin K C Ng Leonard Kritharides Andy S C Yong |
| author_facet | Christopher C Y Wong Austin C C Ng Cuneyt Ada Vincent Chow William F Fearon Martin K C Ng Leonard Kritharides Andy S C Yong |
| author_sort | Christopher C Y Wong |
| collection | DOAJ |
| description | <h4>Background</h4>Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography-guided PCI in randomized controlled studies. However, real-world data on the use and outcomes of FFR-guided PCI remain limited. Thus, we investigated the outcomes of patients undergoing FFR-guided PCI compared to angiography-guided PCI in a large, state-wide unselected cohort.<h4>Methods and results</h4>All patients undergoing PCI between June 2017 and June 2018 in New South Wales, Australia, were included. The cohort was stratified into the FFR-guided group when concomitant FFR was performed, and the angiography-guided group when no FFR was performed. The primary outcome was a combined endpoint of death or myocardial infarction (MI). Secondary outcomes included all-cause death, cardiovascular (CVS) death, and MI. The cohort comprised 10,304 patients, of which 542 (5%) underwent FFR-guided PCI. During a mean follow-up of 12±4 months, the FFR-guided PCI group had reduced occurrence of the primary outcome (hazard ratio [HR] 0.34, 95% confidence intervals [CI] 0.20-0.56, P<0.001), all-cause death (HR 0.18, 95% CI 0.07-0.47, P = 0.001), CVS death (HR 0.21, 95% CI 0.07-0.66, P = 0.01), and MI (HR 0.46, 95% CI 0.25-0.84, P = 0.01) compared to the angiography-guided PCI group. Multivariable Cox regression analysis showed FFR-guidance to be an independent predictor of the primary outcome (HR 0.45, 95% CI 0.27-0.75, P = 0.002), all-cause death (HR 0.22, 95% CI 0.08-0.59, P = 0.003), and CVS death (HR 0.27, 95% CI 0.09-0.83, P = 0.02).<h4>Conclusions</h4>In this real-world study of patients undergoing PCI, FFR-guidance was associated with lower rates of the primary outcome of death or MI, as well as the secondary outcomes of all-cause death and CVS death. |
| format | Article |
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| language | English |
| publishDate | 2021-01-01 |
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| spelling | doaj-art-d4a8ca896763411cb84d01fef65de1eb2025-08-20T02:02:13ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-011612e025966210.1371/journal.pone.0259662A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention.Christopher C Y WongAustin C C NgCuneyt AdaVincent ChowWilliam F FearonMartin K C NgLeonard KritharidesAndy S C Yong<h4>Background</h4>Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography-guided PCI in randomized controlled studies. However, real-world data on the use and outcomes of FFR-guided PCI remain limited. Thus, we investigated the outcomes of patients undergoing FFR-guided PCI compared to angiography-guided PCI in a large, state-wide unselected cohort.<h4>Methods and results</h4>All patients undergoing PCI between June 2017 and June 2018 in New South Wales, Australia, were included. The cohort was stratified into the FFR-guided group when concomitant FFR was performed, and the angiography-guided group when no FFR was performed. The primary outcome was a combined endpoint of death or myocardial infarction (MI). Secondary outcomes included all-cause death, cardiovascular (CVS) death, and MI. The cohort comprised 10,304 patients, of which 542 (5%) underwent FFR-guided PCI. During a mean follow-up of 12±4 months, the FFR-guided PCI group had reduced occurrence of the primary outcome (hazard ratio [HR] 0.34, 95% confidence intervals [CI] 0.20-0.56, P<0.001), all-cause death (HR 0.18, 95% CI 0.07-0.47, P = 0.001), CVS death (HR 0.21, 95% CI 0.07-0.66, P = 0.01), and MI (HR 0.46, 95% CI 0.25-0.84, P = 0.01) compared to the angiography-guided PCI group. Multivariable Cox regression analysis showed FFR-guidance to be an independent predictor of the primary outcome (HR 0.45, 95% CI 0.27-0.75, P = 0.002), all-cause death (HR 0.22, 95% CI 0.08-0.59, P = 0.003), and CVS death (HR 0.27, 95% CI 0.09-0.83, P = 0.02).<h4>Conclusions</h4>In this real-world study of patients undergoing PCI, FFR-guidance was associated with lower rates of the primary outcome of death or MI, as well as the secondary outcomes of all-cause death and CVS death.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0259662&type=printable |
| spellingShingle | Christopher C Y Wong Austin C C Ng Cuneyt Ada Vincent Chow William F Fearon Martin K C Ng Leonard Kritharides Andy S C Yong A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention. PLoS ONE |
| title | A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention. |
| title_full | A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention. |
| title_fullStr | A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention. |
| title_full_unstemmed | A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention. |
| title_short | A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention. |
| title_sort | real world comparison of outcomes between fractional flow reserve guided versus angiography guided percutaneous coronary intervention |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0259662&type=printable |
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