{
  "abstract": "Background: Invasive pressure-wire-based fractional flow reserve (FFR) is the reference standard for physiology-guided coronary revascularization, yet it requires pressure-wire equipment and adenosine-induced hyperemia. Angiography-derived FFR enables functional assessment solely from coronary angiograms, while quantitative pooled evidence from patient-level randomized controlled trials (RCTs) remains limited.\n\nMethods: We searched PubMed, Cochrane Library, Embase and Web of Science Core Collection for eligible RCTs comparing angiography-derived FFR-guided versus wire-based FFR-guided revascularization. The primary endpoint was major adverse cardiovascular events (MACE). Pooled risk ratios or mean differences with 95% confidence intervals were calculated. GRADE assessment and trial sequential analysis (TSA) were performed, and publication bias was evaluated by funnel-plot inspection.\n\nResults: Four RCTs involving 6,542 participants were included. No significant difference in MACE was observed between groups (RR 1.07, 95%CI 0.91-1.27). All-cause mortality, cardiac mortality, recurrent myocardial infarction, unplanned revascularization and stent thrombosis were also comparable. Angiography-derived FFR was associated with higher patients-level PCI rate (RR 1.24, 95%CI 1.15-1.33), lesion-level PCI rate (RR 1.24, 95%CI 1.18-1.31) and shorter procedural time (MD −4.09 min, 95%CI −5.76 to −2.43). TSA showed insufficient sample size for most hard clinical endpoints. GRADE certainty varied across endpoints, procedural outcomes were rated high-certainty, while most clinical outcomes were of moderate certainty and stent thrombosis of low certainty.\n\nConclusions: Relative to wire-based FFR, angiography-derived FFR showed no statistically significant difference in ischaemic-driven clinical outcomes and procedural duration. However, it may increase the likelihood of undergoing PCI. Further large-scale trials with extended follow-up are needed to clarify the long-term implications of this revascularization pattern.\n\nSystematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/ , CRD420261479620.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Cardiology, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital (The Second Clinical College of North Sichuan Medical College)",
    "The Second Clinical College of North Sichuan Medical College"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Peng-Yu Zhong"
    },
    {
      "affs": [
        1
      ],
      "name": "Qing-Yi Yang"
    },
    {
      "affs": [
        1
      ],
      "name": "Liu Lei"
    },
    {
      "affs": [
        0
      ],
      "name": "Lin He"
    },
    {
      "affs": [
        0
      ],
      "name": "Wei Ni"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8ap4yym07w5ah.bib",
  "cited_by": 0,
  "doi": "10.3389/fcvm.2026.1969354",
  "fulltext_url": null,
  "id": "8ap4yym07w5ah",
  "issns": [
    "2297-055X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1969354/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/8ap4yym07w5ah.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "10.3389/fcvm.2026.1969354",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fcvm.2026.1969354/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2297-055X",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Angiography-derived versus wire-based fractional flow reserve for guiding coronary revascularization: a meta-analysis of randomized controlled trials",
  "title_text": "Angiography-derived versus wire-based fractional flow reserve for guiding coronary revascularization: a meta-analysis of randomized controlled trials",
  "type": "peer-reviewed",
  "updated_at": "2026-11-01T00:21:04Z",
  "url": "https://research.draconitic.com/paper/8ap4yym07w5ah",
  "venue": "Frontiers in Cardiovascular Medicine",
  "versions": []
}