Coronary disease & ACSRandomised controlled trial
Long-Term Outcomes After Fractional Flow Reserve vs Intravascular Ultrasound to Guide Percutaneous Coronary Intervention (PCI)
- Randomised controlled trial
- open-label
- multinational
- 18 sites in Korea and China
- extended follow-up
Authors' conclusion
FFR-guided and IVUS-guided treatment strategies resulted in comparable long-term outcomes, with no significant difference in patient-oriented composite outcomes.
Study context
- Population
- Patients aged ≥19 years with de novo intermediate coronary stenosis (40%-70%) and target vessel diameters ≥2.5 mm
- Participants
- 1,682 patients
- Comparison
- Fractional flow reserve (FFR)-guided vs intravascular ultrasound (IVUS)-guided treatment
- FFRn = 838
- IVUSn = 844reference
- Primary endpoint
- Composite of:
- All-cause death
- MI
- Any revascularization after the index procedure
- Follow-up
- Median 6.3 years (Q1-Q3: 5.6-6.9 years)
Primary result
As reported in the abstract
median 6.3 years
Hazard ratio
1.15
95% CI 0.93–1.42
P = 0.208
Events by treatment group
FFR vs IVUS
HR 1.15 (95% CI 0.93–1.42); P = 0.208
Secondary outcomes
| Outcome | FFR | IVUS | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Revascularization after index procedure | 14.9% | 11.8% | 1.32 (1.00–1.75) | P = 0.049 | |
| Target vessel revascularization | 9.6% | 6.2% | 1.67 (1.15–2.43) | P = 0.007 | |
| 0.512Hazard ratio (log scale) |
Overall target vessel PCI (index and follow-up)
P < 0.001
- Revascularization after index procedure: driven primarily by late (2-7 years) revascularizations in vessels with initially deferred PCI
Death or MI
- No statistically significant differences in annual cumulative incidence of death or MI between groups
Original publication
Long-Term Outcomes After Fractional Flow Reserve vs Intravascular Ultrasound to Guide PCI. J Am Coll Cardiol. Published 26 August 2025. doi:10.1016/j.jacc.2025.06.042
Summarised from the published abstract; every number is checked against it