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- Title
FFR‐guided versus coronary angiogram‐guided CABG: A review and meta‐analysis of prospective randomized controlled trials.
- Authors
Timbadia, Dhayan; Ler, Ashlynn; Sazzad, Faizus; Alexiou, Christos; Kofidis, Theo
- Abstract
Background: Fractional flow reserve (FFR) is a well‐established method for the evaluation of coronary artery stenosis before percutaneous coronary intervention. However, whether FFR assessment should be routinely used before coronary artery bypass graft surgery (CABG) remains unclear. A meta‐analysis of prospectively randomized controlled trials (PRCTs) was carried out to compare the outcomes of FFR‐guided CABG vs coronary angiography (CAG)‐guided CABG. Method: The meta‐analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Two PRCTs (the FARGO and GRAFFITI trials) were found and included reporting data on 269 patients with 6 and 12 month follow‐up. Primary endpoints were rates of overall death, MACCE, target vessel revascularization, and spontaneous myocardial infarction (MI). Secondary endpoints were overall graft patency and patency of arterial and venous grafts. Results: There were no significant differences between the FFR‐guided and CAG‐guided groups in the rates of overall death, MACCE, target vessel revascularization, spontaneous MI and graft patency. Meta‐analysis of FARGO and GRAFFITI PRCTs showed that FFR‐guided CABG and CAG‐guided CABG produced similar clinical outcomes with similar graft patency rates up to a year postoperatively. Conclusion: Currently available PRCTs showes no sufficient evidence to support the use FFR in CABG.
- Subjects
FARGO (N.D.); RANDOMIZED controlled trials; CORONARY artery bypass; CORONARY artery stenosis; DRUG-eluting stents; PERCUTANEOUS coronary intervention; TRANSPLANTATION of organs, tissues, etc.
- Publication
Journal of Cardiac Surgery, 2020, Vol 35, Issue 10, p2785
- ISSN
0886-0440
- Publication type
Article
- DOI
10.1111/jocs.14880