# FFR-geleide versus angiografie-geleide revascularisatie: meta-analyse van RCT's

*geplaatst 2022-10-13 · Algemeen · Heart (British Cardiac Society) · doi 10.1136/heartjnl-2021-320768 · https://hartvaat.nl/2022/10/13/ffr-geleide-versus-angiografie-geleide-revascularisatie-meta-analyse-van-rct-s/*

Meta-analyse van gerandomiseerde trials bevestigde dat FFR-geleide revascularisatie minder stentplaatsingen oplevert dan angiografie-geleide revascularisatie, zonder verschil in klinische uitkomsten. FFR reduceert overbodige interventies bij coronairlijden.

## English: Fractional flow reserve versus angiography alone in guiding myocardial revascularisation: a systematic review and meta-analysis of randomised trials.

This meta-analysis confirmed that FFR-guided revascularization results in fewer stent implantations than angiography-guided treatment without compromising clinical outcomes, supporting the value of physiological assessment for treatment selection.

## Abstract (original, from the publication)

BACKGROUND: Randomised trials evaluating the efficacy and safety of fractional flow reserve (FFR)-guided versus angiography-guided revascularisation among patients with obstructive coronary artery disease (CAD) have yielded mixed results. AIMS: To examine the comparative efficacy and safety of FFR-guided versus angiography-guided revascularisation among patients with obstructive CAD. METHODS: An electronic search of MEDLINE, SCOPUS and Cochrane databases without language restrictions was performed through November 2021 for randomised controlled trials that evaluated the outcomes of FFR-guided versus angiography-guided revascularisation. The primary outcome was major adverse cardiac events (MACE). Data were pooled using a random-effects model. RESULTS: The final analysis included seven trials with 5094 patients. The weighted mean follow-up duration was 38 months. Compared with angiography guidance, FFR guidance was associated with fewer number of stents during revascularisation (standardised mean difference=-0.80; 95% CI -1.33 to -0.27), but no difference in total hospital cost. There was no difference between FFR-guided and angiography-guided revascularisation in long-term MACE (13.6% vs 13.9%; risk ratio (RR) 0.97, 95% CI 0.85 to 1.11). Meta-regression analyses did not reveal any evidence of effect modification for MACE with acute coronary syndrome (p=0.36), proportion of three-vessel disease (p=0.88) or left main disease (p=0.50). There were no differences between FFR-guided and angiography-guided revascularisation in the outcomes all-cause mortality (RR 1.16, 95% CI 0.80 to 1.68), cardiovascular mortality (RR 1.27, 95% CI 0.50 to 3.26), repeat revascularisation (RR 0.99, 95% CI 0.81 to 1.21), recurrent myocardial infarction (RR 0.92, 95% CI 0.74 to 1.14) or stent thrombosis (RR 0.61, 95% CI 0.31 to 1.21). CONCLUSION: Among patients with obstructive CAD, FFR-guided revascularisation did not reduce the risk of long-term adverse cardiac events or the individual outcomes. However, FFR-guided revascularisation was associated with fewer number of stents. PROSPERO REGISTRATION NUMBER: CRD42021291596.

Auteurs: Ayman Elbadawi, Ramy Sedhom, Alexander T Dang, Mohamed M Gad, Faisal Rahman, Emmanouil S Brilakis, Islam Y Elgendy, Hani Jneid

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Bron: Heart (British Cardiac Society), https://doi.org/10.1136/heartjnl-2021-320768. Bijgewerkt 2026-07-03T13:29:06Z. 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.