SynthesisBMC cardiovascular disorders2026
Angiography-derived versus pressure-wire-based physiological assessment to guide percutaneous coronary intervention: a systematic review and meta-analysis of randomised controlled trials.
Synthesis in BMC cardiovascular disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
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Abstract
introductionAngiography-derived fractional flow reserve (FFR) has emerged as a wire-free alternative to pressure-wire-based physiological assessment for guiding percutaneous coronary intervention (PCI). However, comparative clinical outcomes and procedural implications remain uncertain.
methodsA systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted in accordance with PRISMA guidelines. Databases were searched from inception to April 2026. Studies comparing angiography-derived FFR with pressure-wire-based strategies in patients undergoing PCI were included. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Pre-specified subgroup analyses were performed based on technology type and comparator composition.
resultsThree RCTs were included. Angiography-derived strategies demonstrated no significant difference compared with wire-based approaches for the primary composite outcome (RR: 1.14; 95% CI: 0.85 to 1.55), all-cause mortality, cardiac mortality, myocardial infarction (MI), or revascularization. However, angiography-derived guidance significantly reduced procedural time (MD: - 2.83 min; 95% CI: - 4.94 to - 0.72), fluoroscopy time (MD: - 2.50 min; 95% CI: - 3.38 to - 1.61), and contrast volume (MD: - 6.99 mL; 95% CI: - 11.57 to - 2.40).
conclusionsAngiography-derived physiological assessment provides comparable 1-year clinical outcomes to pressure-wire-based strategies while improving procedural efficiency. However, outcomes may vary by platform, highlighting the importance of technology-specific evaluation in future research.
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