{"id":"42d577a7bf8d","type":"article","url":"https://hartvaat.nl/2019/01/07/ffr-geleide-pci-versus-medicamenteuze-therapie-bij-stabiele-coronairlaesies-meta/","title":"FFR-geleide PCI versus medicamenteuze therapie bij stabiele coronairlaesies: meta-analyse","title_en":"Fractional flow reserve-guided percutaneous coronary intervention vs. medical therapy for patients with stable coronary lesions: meta-analysis of individual patient data.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["stabiel-coronairlijden"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehy812","source_url":"https://doi.org/10.1093/eurheartj/ehy812","authors":["Frederik M Zimmermann","Elmir Omerovic","Stephane Fournier","Henning Kelbæk","Nils P Johnson","Martina Rothenbühler","Panagiotis Xaplanteris","Mohamed Abdel-Wahab","Emanuele Barbato","Dan Eik Høfsten","Pim A L Tonino","Bianca M Boxma-de Klerk","William F Fearon","Lars Køber","Pieter C Smits","Bernard De Bruyne","Nico H J Pijls","Peter Jüni","Thomas Engstrøm"],"significance":7,"published":"2019-01-07","source_date":"2019-01-07","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/"],"congress":"","summary_en":"This meta-analysis confirmed that FFR-guided PCI with contemporary drug-eluting stents reduces cardiovascular events compared with medical therapy alone in patients with stable coronary lesions, consolidating the evidence for physiologically guided revascularization.","created":"2026-07-03T10:27:43Z","updated":"2026-07-03T13:26:56Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse die FFR-geleide PCI vergeleek met medicamenteuze therapie bij stabiele coronairlaesies. Consolideert het FFR-evidence.","abstract_original":"AIMS: To assess the effect of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with contemporary drug-eluting stents on the composite of cardiac death or myocardial infarction (MI) vs. medical therapy in patients with stable coronary lesions. METHODS AND RESULTS: We performed a systematic review and meta-analysis of individual patient data (IPD) of the three available randomized trials of contemporary FFR-guided PCI vs. medical therapy for patients with stable coronary lesions: FAME 2 (NCT01132495), DANAMI-3-PRIMULTI (NCT01960933), and Compare-Acute (NCT01399736). FAME 2 enrolled patients with stable coronary artery disease (CAD), while the other two focused on non-culprit lesions in stabilized patients after acute coronary syndrome. A total of 2400 subjects were recruited from 54 sites world-wide with 1056 randomly assigned to FFR-guided PCI and 1344 to medical therapy. The pre-specified primary outcome was a composite of cardiac death or MI. We included data from extended follow-ups for FAME 2 (up to 5.5 years follow-up) and DANAMI-3-PRIMULTI (up to 4.7 years follow-up). After a median follow-up of 35 months (interquartile range 12-60 months), a reduction in the composite of cardiac death or MI was observed with FFR-guided PCI as compared with medical therapy (hazard ratio 0.72, 95% confidence interval 0.54-0.96; P = 0.02). The difference between groups was driven by MI. CONCLUSION: In this IPD meta-analysis of the three available randomized controlled trials to date, FFR-guided PCI resulted in a reduction of the composite of cardiac death or MI compared with medical therapy, which was driven by a decreased risk of MI."}