title: Comparing treatment outcomes of fractional flow reserve-guided and angiography-guided percutaneous coronary intervention in patients with multi-vessel coronary artery diseases: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is used to assess the need for angioplasty in vessels with intermediate blockages. The treatment outcomes of FFR-guided vs. conventional angiography-guided PCI were evaluated in patients with multi-vessel coronary artery disease (CAD).
  
  
  METHODS
  Prospective and retrospective studies comparing FFR-guided vs. angiography-guided PCI in patients with multi-vessel CAD were identified from medical databases by two independent reviewers using the terms "percutaneous coronary intervention, fractional flow reserve, angiography, coronary heart disease, major adverse cardiac events (MACE) and myocardial infarction". The primary outcome was the number of stents placed, and the secondary outcomes were procedure time, mortality, myocardial infarction (MI) and MACE rates.
  
  
  RESULTS
  Seven studies (three retrospective and four prospective), which included 49,517 patients, were included in this review. A total of 4,755 patients underwent FFR, while 44,697 received angiography-guided PCI. The mean patient age ranged from 58 to 71.7 years. The average number of stents used in FFR patients ranged from 0.3-1.9, and in angiography-guided PCI patients ranged from 0.7-2.7. Analysis indicated there was a greater number of stents placed in the angiography-guided group compared with the FFR group (pooled difference in means: -0.64, 95% confidence interval [CI]: -0.81 to -0.47, P < 0.001). There were no differences in the secondary outcomes between the two groups.
  
  
  CONCLUSIONS
  Both procedures produce similar clinical outcomes, but the fewer number of stents used with FFR may have clinical as was as cost implications.
authors.affiliation: . email@email.com.
authors.forename: Jiancheng
authors.initials: J
authors.lastname: Xiu
authors.forename: Gangbin
authors.initials: G
authors.lastname: Chen
authors.forename: Hua
authors.initials: H
authors.lastname: Zheng
authors.forename: Yuegang
authors.initials: Y
authors.lastname: Wang
authors.forename: Haibin
authors.initials: H
authors.lastname: Chen
authors.forename: Xuewei
authors.initials: X
authors.lastname: Liu
authors.forename: Juefei
authors.initials: J
authors.lastname: Wu
authors.forename: Jianping
authors.initials: J
authors.lastname: Bin
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology