SynthesisBMC cardiovascular disorders2025
Evaluation of the relative benefits of FFR-guided, angiography-guided CR or culprit-only revascularization in patients with multivessel coronary disease: a systematic review and meta-analysis.
Synthesis in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Diffusely impaired myocardial perfusion in patients with suspected coronary artery disease: Clinical utility of relative perfusion.Clinical physiology and functional imaging · 2026Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAt present, the benefits associated with fractional flow reserve (FFR)-guided complete revascularization (CR) for instances of non-culprit stenosis in patients of coronary artery disease (CAD) affected by multivessel disease (MVD) remain poorly understood. This systematic review and meta-analysis was undertaken to clarify the cardiovascular benefits associated with FFR-guided and angiography-guided CR in patients with CAD and MVD.
methodsThe PubMed, Embase, and Cochrane databases were searched to locate randomized control trials (RCTs) comparing FFR-guided CR with angiography-guided CR or culprit-only percutaneous intervention (PCI). The primary outcome is major adverse cardiovascular events (MACE), as well as secondary outcomes were all-cause mortality, cardiac mortality, recurrent myocardial infarction (MI) incidence. Primary and secondary outcomes were compared among groups using DerSimonian and Laird random-effects models.
resultsTen RCTs enrolling 7249 participants were included. No significant differences were found between FFR- and angiography-guided CR use in patients with CAD and MVD in terms of MACE (RR: 0.88, 95%CI: 0.69-1.12, P = 0.302), cardiac mortality (RR: 0.90, 95%CI: 0.45-1.80. P = 1.000), recurrent MI (RR: 0.83, 95%CI: 0.55-1.25, P = 0.376), repeat revascularization (RR: 0.93, 95%CI: 0.71-1.21, P = 0.574), or target lesion revascularization (TLR; RR: 0.90, 95%CI: 0.33-2.48 P = 0.840). All-cause mortality was similar between the groups (RR: 1.00, 95%CI: 0.57-1.75, P = 1.000). Relative to culprit-only PCI, FFR-guided CR was associated with reduced risk of repeat revascularization (RR: 0.50, 95%CI: 0.37-0.68, P < 0.001) and TLR (RR: 0.31, 95%CI: 0.2-0.48, P < 0.001), while MACE incidence did not differ significantly between the two groups (RR: 0.72, 95%CI: 0.51-1.01, P = 0.006), nor did all-cause mortality (RR: 1.09, 95%CI: 0.84-1.42, P = 0.526), cardiac mortality (RR: 0.82, 95%CI: 0.55-1.21, P = 0.312), or recurrent MI (RR: 0.85, 95%CI: 0.73-1.24, P = 0.713).
conclusionFFR-guided CR was found to linked with reduced repeat revascularization and TLR in individuals with CAD and MVD in comparison with culprit-only PCI. While no significant difference was detected between FFR-guided and angiography-guided CR procedures for the analyzed cardiovascular outcomes, a lower absolute number of adverse events was noted with FFR-guided CR. These findings indicate that the FFR-guided CR of non-culprit vessels may help reduce the need for the implantation of stents in patients with CAD and MVD without any adverse impact on their prognostic outcomes.
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