Coronary disease & ACSMeta-analysis
Fractional flow reserve vs angiography to guide percutaneous coronary intervention: an individual patient data meta-analysis
- Individual patient data meta-analysis of randomised controlled trials
Authors' conclusion
Fractional flow reserve-guided PCI was associated with reduced major adverse events in patients with CCS and NSTE-ACS due mainly to fewer peri-procedural MIs, with no differences in mortality or MACE beyond 30 days.
Study context
- Population
- Intermediate coronary lesions in chronic coronary syndrome or non-culprit vessels in non-ST-elevation acute coronary syndromes (NSTE-ACS)
- Participants
- 2,493 lesions · 5 randomized controlled trials (RCTs)
- Comparison
- Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) vs angiography-guided PCI
- FFRn = 1,252
- Angiographyn = 1,241reference
- Outcome
- MACE:
- All-cause death
- MI
- Repeat revascularization
- Follow-up
- 1 year
Pooled result
As reported in the abstract
Hazard ratio
.80
95% CI .64-.99
P = 0.046
By group
Further pooled results
Vessels undergoing PCI
P < 0.001
| Outcome | FFR | Angiography | HR (95% CI) | P value |
|---|---|---|---|---|
| MI | .71 (.53-.96) | P = 0.031 | ||
| Stents implanted per patient | 1.5 (IQR 1.0–2.0) | 2.0 (IQR 2.0–3.0) | P < 0.001 |
- Myocardial infarction (MI): driven by a reduction in peri-procedural MI with FFR guidance
Non-procedural MI, major adverse cardiac events (MACE) between 30 days and 1 year, other secondary outcomes
- No significant difference between groups
Original publication
Fractional flow reserve vs angiography to guide percutaneous coronary intervention: an individual patient data meta-analysis. Eur Heart J. Published 20 August 2025. doi:10.1093/eurheartj/ehaf504
Summarised from the published abstract; every number is checked against it