Comparison of intracoronary versus intravenous adenosine‐induced maximal hyperemia for fractional flow reserve measurement: A systematic review and meta‐analysis

Objective We sought to perform a systematic review and meta‐analysis of the available literature comparing fractional flow reserve (FFR) measurements after administration of adenosine using intracoronary (IC) bolus versus standard continuous intravenous (IV) infusion. Background FFR is considered th...

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Bibliographic Details
Published in:Catheterization and cardiovascular interventions 2019-11, Vol.94 (5), p.714-721
Main Authors: Abo‐Aly, Mohamed, Lolay, Georges, Adams, Christopher, Ahmed, Ahmed Elsharawy, Abdel‐Latif, Ahmed, Ziada, Khaled M.
Format: Article
Language:English
Subjects:
Adenosine
coronary angiography
coronary stenosis
Dosage
fractional flow reserve
Hemodynamics
Hyperemia
Intravenous administration
Lesions
Likelihood ratio
Meta-analysis
Side effects
Systematic review
vasodilator agents
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Summary:Objective We sought to perform a systematic review and meta‐analysis of the available literature comparing fractional flow reserve (FFR) measurements after administration of adenosine using intracoronary (IC) bolus versus standard continuous intravenous (IV) infusion. Background FFR is considered the gold standard for invasive assessment of coronary lesions of intermediate severity. IV adenosine is recommended to induce hyperemia; however, IC adenosine is widely used for convenience. The difference between IV and IC administration in lesions assessment is not well studied. Methods We systematically searched MEDLINE and relevant databases for studies comparing IV with IC adenosine administration for FFR measurement. We reviewed data pertaining to adenosine doses, side effects, and FFR values. Results Eight studies addressing the primary question were identified. Dose of IC adenosine varied between 36 and 600 μg. Compared to IV adenosine infusion, the sensitivity of IC administration is 0.805 (95% confidence interval [95% CI]: 0.664–0.896; p 
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.28317