Trial reportThe New England journal of medicine2009
Fractional flow reserve versus angiography for guiding percutaneous coronary intervention.
Trial report in The New England journal of medicine, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 29 registered trials, which are not on this map. Cited by 1,368 papers, 10 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Effect of the Antidiabetic Drug DAPAgliflozin on the Coronary Macrovascular and MICROvascular Function in Type 2 Diabetic Patients
Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (F.A.M.E.)
Utilization of Lexiscan (Regadenoson)in the Cardiac Catheterization Lab to Achieve Maximal Hyperemia for Coronary Physiologic Assessment With Fractional Flow Reserve
A Developmental Clinical Study of Management Guided by Coronary Angiography Combined With Fractional Flow Reserve (FFR) Measurement Versus Management Guided by Coronary Angiography Alone(Standard Care) in Patients With Non-ST Elevation MI.
Influence of Fractional Flow Reserve (FFR) on the Clinical OutcomEs of PERcutaneouS Coronary Intervention (PCI): A ProspECTIVE, Multicenter FFR Registry
Revascularization With Paclitaxel-coated Balloon Angioplasty Versus Drug-eluting Stenting in Acute Myocardial Infarction - a Randomized Controlled Trial.
Impact of Preoperative FFR on Arterial Bypass Graft Functionality: Towards a New CABG Paradigm
Assessment of Catheter-based Interrogation and Standard Techniques for Fractional Flow Reserve Measurement: the ACIST-FFR Study
Safety of Negative FrActional Flow Reserve in Patients With ChallEnging Lesions
A Randomised Controlled Trial to Compare Routine Pressure Wire Assessment With Conventional Angiography in the Management of Patients With Coronary Artery Disease.
FLOW Evaluation to Guide Revascularization in Multi-vessel ST-elevation Myocardial Infarction
FFR Versus iFR in Assessment of Hemodynamic Lesion Significance Using Gene Polymorphisms and Lesion Morphology Assessed by OCT (FiGARO Trial)
Effect of Ranolazine on Activity Level in Patients With Angina After FFR Based Deferred Intervention
Evaluation of the Opsens Fractional Flow Reserve (FFR) Wire as a "Work Horse" Wire
Comparison of Dobutamine Stress Echocardiography and Fractional Flow Reserve in Patients With Moderate Coronary Artery Disease: Stable and Non-culprit Lesions Investigation
Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous InterVention in Patients With cORonary Artery Disease (The FAVOR III China Study)
Concordance Between FFR and iFR for the Assessment of Intermediate Lesions in the Left Main Coronary Artery. A Prospective Validation of a Default Value for iFR (iLITRO Study)
Assessment of NOn-culprit Lesions With dobutamiNe Stress eChocardiography, compUted Tomography and Fractional fLow Reserve in Patients With Acute
CCTA-FFR Registry for Development of Comprehensive Risk Prediction Model
Angiographic Control Vs. Ischemia-driven Management of Patients Undergoing Percutaneous Revascularization of the Unprotected Left Main Coronary Artery with Second-generation Drug Eluting Stents: the PULSE Trial
Impact of Stenosis and Plaque Features in Coronary CT Angiography, Physiologic Assessment and Pharmacotherapy on the Clinical Outcomes After Invasive Coronary Angiography
A Prospective, Multicenter, Blinded, Randomized, Noninferiority Clinical Trial of Coronary Angiography Fractional Flow Reserve (caFFR) Versus Fractional Flow Reserve (FFR) to Guide Percutaneous Coronary Intervention（Flash FFR Ⅱ ）
Evaluation of Diagnostic Accuracy, Safety, and Cost-Effectiveness of the Non-Invasive Cardiolens FFR-CT Pro Method to Measure the Fractional Flow Reserve in Diagnostics of Chronic Coronary Syndromes Versus the Standard Diagnostic Modalities. A Multicentre Post-marketing Trial of a Class 2a Medical Device, Cardiolens FFR-CT Pro - Software for Non-invasive Determination of Haemodynamic Parameters in Coronary Arteries.
Effects of Guiding Catheter on Fractional Flow Reserve and Non-Hyperemic Pressure Ratios for the Assessment of Coronary Artery Stenoses - Disengage @Rest
An Interventional Strategy for Non-culprit Lesions With Major Vulnerability Criteria Identified by Optical Coherence Tomography in Patients With Acute Coronary Syndrome (the INTER-CLIMA Trial)
Oxygen-enhanced Magnetic Resonance Imaging (OE-MRI) of the Heart: A Feasibility Study
Clinical Outcomes of Patients With Coronary Artery Disease Cohort Study
Diagnostic Accuracy of Quantitative Flow Ratio for Hemodynamic Assessment of Coronary Artery Stenosis: Prospective Observational Study
Association Between Murray Law-Based Angiography-Derived Fractional Flow Reserve and Outcomes After Coronary Artery Bypass Grafting
Who cites it
1,368 citing papers in PubMed, 10 syntheses or guidelines pooled it, 4,152 citations in OpenAlex.
- Murray law-based quantitative flow ratio for functional assessment of coronary lesions: a systematic review and meta-analysis.The international journal of cardiovascular imaging · 2026Pooled it
- Angiography-derived versus pressure-wire-based physiological assessment to guide percutaneous coronary intervention: a systematic review and meta-analysis of randomised controlled trials.BMC cardiovascular disorders · 2026Pooled it
- Pooled it
- Diagnostic Performance of Non-Hyperemic Pressure Ratios Versus Fractional Flow Reserve Stratified by Coronary Artery: A Systematic Review and Meta-Analysis of Individual Patient Data.Journal of the American Heart Association · 2026Pooled it
- Comparative Outcomes of Fractional Flow Reserve and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention in Intermediate Lesions: A Systematic Review and Meta-Analysis.Cardiovascular therapeutics · 2026Pooled it
- 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.BMC cardiovascular disorders · 2025Pooled it
- Impact of percutaneous coronary intervention with different guidance modalities in patients with coronary artery lesions: a network meta-analysis and systematic review.Frontiers in cardiovascular medicine · 2025Pooled it
- Fractional flow reserve-guided complete vs. culprit-only revascularization in ST-elevation myocardial infarction patients with multivessel disease: a meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Updated meta-analysis of fractional flow reserve versus coronary angiography for guiding percutaneous coronary intervention.PloS one · 2025Pooled it
- Comparison of intravascular imaging, physiological assessment and angiography for coronary revascularization in acute coronary syndrome: a systematic review and network meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Angiography-Derived FFR Versus IVUS to Guide PCI According to Angiographic Lesion Characteristics.Circulation. Cardiovascular interventions · 2026Trial
- Determining the Physiological Threshold for Angina (ORBITA-FIRE): A Double-Blind, Randomized, Placebo-Controlled Study.Circulation · 2026Trial
- Prognostic impact of guideline-directed medical therapy after functionally complete revascularisation in patients with obstructive coronary artery diseases.Heart (British Cardiac Society) · 2026Trial
- Fractional flow reserve-guided percutaneous coronary intervention versus medical therapy for stable coronary artery disease: long-term results of the FAME 2 trial.Nature medicine · 2026Trial
- Changes in non-culprit coronary lesions with PCSK9 inhibitors: the randomised, placebo-controlled FITTER trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Trial
- Cost-effectiveness of angiographic quantitative flow ratio-guided coronary intervention: A multicenter, randomized, sham-controlled trial.Chinese medical journal · 2025Trial
- Angiographic Quantitative Flow Ratio-Guided Treatment of Patients With Physiologically Intermediate Coronary Lesions.Journal of the American Heart Association · 2025Trial
- Coronary revascularisation deferral based on quantitative flow ratio or fractional flow reserve: a post hoc analysis of the FAVOR III Europe trial.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025Trial
- Relationship Between Severity of Ischemia and Coronary Artery Disease for Different Stress Test Modalities in the ISCHEMIA Trial.Circulation. Cardiovascular interventions · 2024Trial
- Diffusely impaired myocardial perfusion in patients with suspected coronary artery disease: Clinical utility of relative perfusion.Clinical physiology and functional imaging · 2026Article
1,308 more citing papers are in PubMed but not listed here.
Corrections and comments
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- Commented on by[Not Available].2009
Authors and funding
14 authors at 9 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients with multivessel coronary artery disease who are undergoing percutaneous coronary intervention (PCI), coronary angiography is the standard method for guiding the placement of the stent. It is unclear whether routine measurement of fractional flow reserve (FFR; the ratio of maximal blood flow in a stenotic artery to normal maximal flow), in addition to angiography, improves outcomes.
methodsIn 20 medical centers in the United States and Europe, we randomly assigned 1005 patients with multivessel coronary artery disease to undergo PCI with implantation of drug-eluting stents guided by angiography alone or guided by FFR measurements in addition to angiography. Before randomization, lesions requiring PCI were identified on the basis of their angiographic appearance. Patients assigned to angiography-guided PCI underwent stenting of all indicated lesions, whereas those assigned to FFR-guided PCI underwent stenting of indicated lesions only if the FFR was 0.80 or less. The primary end point was the rate of death, nonfatal myocardial infarction, and repeat revascularization at 1 year.
resultsThe mean (+/-SD) number of indicated lesions per patient was 2.7+/-0.9 in the angiography group and 2.8+/-1.0 in the FFR group (P=0.34). The number of stents used per patient was 2.7+/-1.2 and 1.9+/-1.3, respectively (P<0.001). The 1-year event rate was 18.3% (91 patients) in the angiography group and 13.2% (67 patients) in the FFR group (P=0.02). Seventy-eight percent of the patients in the angiography group were free from angina at 1 year, as compared with 81% of patients in the FFR group (P=0.20).
conclusionsRoutine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point of death, nonfatal myocardial infarction, and repeat revascularization at 1 year. (ClinicalTrials.gov number, NCT00267774.)
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.