SynthesisReviews in cardiovascular medicine2025
Clinical Outcomes Following Discordance Between Fractional Flow Reserve and Instantaneous Wave-Free Ratio in Deferred Coronary Lesions: A Systematic Review and Meta-Analysis.
Synthesis in Reviews in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
10 authors.
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Abstract
Background: Current guidelines recommend the use of either fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) for assessing intermediate coronary stenoses. However, FFR/iFR discordance occurs in approximately 20% of cases. This systematic review and meta-analysis aimed to investigate whether deferring lesions with discordant FFR/iFR classification is associated with worse prognosis compared to those with negative concordant results (FFR-/iFR-). Methods: A systematic search was conducted in literature repositories to identify all studies that compared the clinical prognosis of deferred lesions with discordant and concordant FFR/iFR results. The primary endpoint was a composite clinical outcome of the individual secondary endpoints (death, myocardial infarction, and revascularization). Results: Three eligible observational studies (1735 deferred vessels) were included in the meta-analysis. Overall, deferred lesions with FFR/iFR discordance presented numerically higher event rates for all primary and secondary endpoints compared to deferred lesions with negative concordance; however, none reached statistical significance. Deferred lesions with FFR-/iFR+ discordance were significantly associated with an increased risk of death (odds ratio [OR]: 3.19; Conclusions: Compared to deferred lesions with negative concordant results, deferred lesions with discordant FFR/iFR results were overall not significantly associated with worse clinical outcomes; however, there was a significantly greater risk of death for deferred lesions specifically with FFR-/iFR+ discordance, and an increased risk of revascularization for deferred lesions with FFR+/iFR- discordance. Further dedicated trials are needed to improve guidance in clinical decision-making. The PROSPERO Registration: CRD420251135424, https://www.crd.york.ac.uk/PROSPERO/view/CRD420251135424.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.