Coronary disease & ACSMeta-analysis
Clinical outcomes of fractional flow reserve (FFR)-guided revascularisation of non-culprit lesions in NSTE-ACS
- Individual patient data pooled analysis of five randomised clinical trials
- stratified according to the coronary syndrome subtype
Authors' conclusion
FFR-guided revascularisation is associated with a similar clinical benefit in NSTE-ACS and CCS settings. An FFR-guided strategy should be considered to safely reduce unnecessary PCI in patients with NSTE-ACS.
Study context
- Population
- Patients with NSTE-ACS and chronic coronary syndrome (CCS) undergoing FFR- or angiography-guided percutaneous coronary intervention (PCI)patients considered · CCS 1,316 (52.8%) · NSTE-ACS 1,177 (47.2%)
- Participants
- 2,493 patients
- Comparison
- FFR-guided vs angiography-guided
- Outcome
- Major adverse cardiovascular events (MACE)
- Follow-up
- 1 year
Pooled result
As reported in the abstract
FFR-guided vs angiography-guidedHazard ratio (95% CI)
CCS
0.78(0.58–1.05)
NSTE-ACS
0.86(0.63–1.18)
Further pooled results
All-cause death, myocardial infarction and repeat revascularisation, by coronary syndrome subtype
- Similar findings
- all-cause death p-int=0.459
- myocardial infarction p-int=0.996
- repeat revascularisation p-int=0.290
Extended exploratory analysis · 5 years of follow-up
- Results confirmed
- exploratory
Number of deferred lesions and risk of major adverse cardiovascular events (MACE) (NSTE-ACS, FFR-guided)
- Not associated with an increased risk of MACE
Original publication
Clinical outcomes of FFR-guided revascularisation of non-culprit lesions in NSTE-ACS. EuroIntervention. Published 21 September 2026. doi:10.4244/eij-d-26-00055
Summarised from the published abstract; every number is checked against it