Angiography-derived fractional flow reserve versus coronary angiography to guide coronary artery bypass grafting in patients undergoing surgical valve procedures with concomitant coronary artery disease in China (FAVOR IV-QVAS): a multicentre, triple-blind, randomised trial
Authors' conclusion
Among patients undergoing valve surgery with concomitant coronary artery disease, physiologically guided CABG using angiography-derived FFR reduced the incidence of the composite perioperative outcome compared with anatomically guided CABG.
Study context
- Population
- Adults scheduled for valve surgery with ≥1 clinically significant stenosis in a major coronary artery
- Participants
- 793 adults
- Comparison
- Physiologically guided coronary artery bypass grafting (CABG) vs anatomically guided CABG
- Angiography-derived fractional flow reserve (FFR)n = 396
- Coronary angiographyn = 397reference
- Primary endpoint
- Composite of:
- Death
- MI
- Stroke
- Unplanned coronary revascularisation
- New renal failure requiring dialysis
- Follow-up
- Within 30 days after surgery
Methodological detailsinvestigator-initiated, multicentre, triple-blind, 12 tertiary hospitals in China, Concomitant CABG done in 223 (56%) FFR vs 388 (98%) angiography patients
- Investigator-initiated
- Multicentre
- Triple-blind
- 12 tertiary hospitals in China
- Concomitant CABG done in 223 (56%) FFR vs 388 (98%) angiography patients
Primary result
As reported in the abstract
Each group vs coronary angiographyAbsolute difference, percentage points (95% CI)P value
Angiography-derived FFR
−5.6(−9.9 to −1.3)
P = 0.011Each group vs coronary angiographyRisk ratio (95% CI)P value
Angiography-derived FFR
0.58(0.38–0.89)
P = 0.011Secondary outcomes
Death · within 30 days
| Outcome | Angiography-derived FFR | Coronary angiography | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Key secondary: death, MI, stroke, unplanned coronary revascularisation, hospitalisation for unstable angina or HF · median follow-up 27 months | 20.7% | 26.8% | 0.74 (0.55–0.98) | P = 0.036 | |
| 0.512Hazard ratio (log scale) |
Original publication
Angiography-derived fractional flow reserve versus coronary angiography to guide coronary artery bypass grafting in patients undergoing surgical valve procedures with concomitant coronary artery disease in China (FAVOR IV-QVAS): a multicentre, triple-blind, randomised trial. Lancet. Published 21 March 2026. doi:10.
Summarised from the published abstract; every number is checked against it