{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T18:23:22Z","timestamp":1750357402920},"reference-count":31,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T00:00:00Z","timestamp":1405641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Deferral of revascularization for abnormal but nonischemic lesions is usually recommended; however, the long\u2010term outcome of this approach is not well known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Deferral of nonischemic lesions will be associated with a low frequency of adverse events.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A <jats:styled-content style=\"fixed-case\">PubMed<\/jats:styled-content> search of the <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content> database identified studies that reported clinical outcomes among patients who had fractional flow reserve\u2010guided revascularization. We further categorized studies into 2 subgroups: left main and non\u2013left main coronary artery lesions. Baseline demographics and clinical outcome data were extracted by 3 independent reviewers. Fixed and random effects summary risk ratios were constructed using Mantel\u2010Haenszel and <jats:styled-content style=\"fixed-case\">DerSimonian<\/jats:styled-content>\u2010Laird models, respectively. The primary outcome was the composite of death, myocardial infarction, and revascularization.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 741 potential studies, 17 were included in the meta\u2010analysis (n\u2009=\u20092975 participants), 8 in the left main subgroup (n\u2009=\u2009595) and 9 studies (n\u2009=\u20092380) in non\u2013left main subgroup. In the left main subgroup, the incidence of the composite outcome was 15.3% in the no\u2010ischemia\/deferral group vs 14.3% in the ischemia\/revascularization group (risk ratio [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>]\u2009=\u20091.13, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]: 0.76\u20101.68, <jats:italic>P<\/jats:italic> = 0.54, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20093.7%). In the non\u2013left main subgroup, the incidence of the composite outcome was 9.2% in the no\u2010ischemia\/deferral group vs 18.8% in the ischemia\/revascularization group (RR\u2009=\u20090.42, 95% CI: 0.34\u20100.52, <jats:italic>P<\/jats:italic> &lt; 0.0001, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200920.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with left main coronary disease had a relatively high incidence of adverse cardiovascular events, which was similar in both the deferral and revascularization groups. In patients with non\u2013left main disease, ischemia was associated with worse outcomes despite revascularization.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22314","type":"journal-article","created":{"date-parts":[[2014,7,18]],"date-time":"2014-07-18T22:17:20Z","timestamp":1405721840000},"page":"610-617","source":"Crossref","is-referenced-by-count":5,"title":["Outcomes Associated With Fractional Flow\u2010Guided Revascularization: A Meta\u2010analysis"],"prefix":"10.1002","volume":"37","author":[{"given":"Anthony A.","family":"Bavry","sequence":"first","affiliation":[{"name":"North Florida\/South Georgia Veterans Health System Gainesville Florida"},{"name":"Division of Cardiovascular Medicine University of Florida Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Islam Y.","family":"Elgendy","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Florida Gainesville 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