ABC | Volume 111, Nº4, Octuber 2018

Original Article Martins ACS Fractional flow reserve-guided strategy Arq Bras Cardiol. 2018; 111(4):542-550 Table 1 – Characteristics of included studies Author Year Follow up Study design Total FU Age (yrs) Men Non-ACS (n) ACS (n) STEMI (n) NSTEMI/ UA (n) FFR value used to defer Median time between Clinical presentation and FFR measurement Multivessel disease Adenosine administration Exclusion criteria Potvin JM et al 9 2006 11 ± 6 months Retrospective cohort 201 62 ± 10 131 61 124 11 113 ≥ 0.75 24 hours (range 2 to 144) NR intracoronary administration of adenosine (median dose 60 μg, range 30 to 300, for the left coronary artery and 30 μg, range 18 to 120, for the right coronary artery) and/ or nitroprusside (median dose 250 μg, range 100 to 1,000, for the left and right coronary arteries). Intracoronary adenosine was used in 135 cases, intracoronary nitroprusside in 14 cases, and adenosine and nitroprusside in 52 cases Patients within 24 hours of acute STEMI were excluded Fischer J et al 8 2006 12 months Retrospective cohort 111 ACS → 58 ± 14 Non-ACS → 63 ± 10 72 76 35 11 24 ≥ 0.75 Recent (within 7 days) ST segment elevation MI treated with lytic Therapy ACS → 9 Non-ACS → 9 intracoronary adenosine (30 μg bolus in the right coronary artery or 40–60 μg bolus in the left coronary artery NR Sels et al 24 2011 2 years Prospective cohort 1005 ACS → 64.8 ± 10.7 Non-ACS → 64.3 ± 10 744 677 328 0 328 ≥ 0.80 NR NR Intravenous adenosine, administered at a rate of 140 μg/kg/min through a central vein. Exclusion criteria were left main disease, previous CABG, and STEMI < 5 days before, because the use of FFR is not validated in recent STEMI. Patients admitted for UAand NSTEMI with positive troponin but total creatine kinase < 1,000 U/l could be included Mehta et al 25 2015 3.4 ± 1.6 years Retrospective cohort 674 ACS → 63.8 ± 11.9 Non-ACS → 65.3 ± 10.2 380 340 334 7 327 > 0.80 NR ACS → 221 Non-ACS → 209 Predominant use of intracoronary adenosine with similar maximum doses for both groups (120 μg) NR Hakeem A et al 34 2016 3,4 ± 1,6 anos Retrospective cohort 576 ACS → 66.6 ± 8 Non-ACS → 64.7 ± 8.7 554 370 206 0 206 > 0.75 NR ACS → 135 Non-ACS → 216 Intravenous (140 mg/kg/min) or intracoronary (at least 60 mg) adenosine. The median dose of intracoronary adenosine in our cohort was 130 mg NR Van Belle et al 38 2017 1 year Retrospective cohort 958 ACS → 66 ± 11.2 Non-ACS → 66.4 ± 10 693 721 237 - - > 0.75 e > 0.80 NR NR NR NR Lee JM et al 37 2017 722 days Retrospective cohort 1596 ACS → 62.0 ± 11.1 Non-ACS → 62.4 ± 9.4 1112 1295 301 0 301 > 0.80 NR NR Hyperemia was induced with an intracoronary bolus administration (80 μg in left coronary artery, 40 μg in right coronary artery), intracoronary (240 μg/ min) or, iv continuous infusion (140 μg/Kg/min) of adenosine. NR FU: Follow-up; yrs: years; ACS: acute coronary syndrome; STEMI: ST segment elevation myocardial infarction; NSTEMI: non- ST segment elevation myocardial infarction; UA: unstable angina; FFR: fractional flow reserve; PCI: Percutaneous coronary intervention; MI: Myocardial Infarction; TVR: target vessel revascularization; CABG: Coronary artery bypass grafting; NR: not reported. 545