Comparative Outcomes of Fractional Flow Reserve and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention in Intermediate Lesions: A Systematic Review and Meta-Analysis.

There was no significant difference in MACE between FFR-guided and IVUS-guided PCI.

• RR = 1.13, 95% CI 0.89–1.44
• Six studies comprising 5040 patients were included (FFR: 2517; IVUS: 2523)
• Random effects modelling was used for all outcomes
• Subgroup analyses by study design (observational studies and randomised control trials) showed no significant effect modification for MACE

All-cause mortality did not differ significantly between FFR-guided and IVUS-guided PCI.

• RR = 0.82, 95% CI 0.41–1.64
• Analysis included 5040 patients across six studies
• Random effects modelling was applied
• Subgroup analyses by study design showed no significant effect modification

Cardiac death rates were not significantly different between FFR-guided and IVUS-guided PCI.

• RR = 1.05, 95% CI 0.60–1.85
• Six studies comprising 5040 patients were included
• Random effects modelling was used
• Subgroup analyses by study design showed no significant effect modification

Nonfatal myocardial infarction rates were not significantly different between FFR-guided and IVUS-guided PCI.

• RR = 1.35, 95% CI 0.72–2.52
• Analysis included 5040 patients across six studies
• Random effects modelling was applied
• Subgroup analyses by study design showed no significant effect modification

Target vessel revascularisation (TVR) rates were not significantly different between FFR-guided and IVUS-guided PCI.

• RR = 1.21, 95% CI 0.81–1.81
• Six studies comprising 5040 patients were included
• Random effects modelling was used
• Subgroup analyses by study design showed no significant effect modification

There was no significant difference in the number of PCI procedures performed between FFR-guided and IVUS-guided groups, though heterogeneity was high.

• RR = 0.78, 95% CI 0.59–1.02
• Heterogeneity was high with I2 = 95%
• This was a secondary outcome of the meta-analysis
• Random effects modelling was used

The meta-analysis included six studies with a total of 5040 patients comparing FFR- and IVUS-guided PCI.

• FFR group: 2517 patients; IVUS group: 2523 patients
• Studies included both observational studies and randomised controlled trials
• The population comprised patients with intermediate coronary lesions
• Both advanced guidance techniques were compared against outcomes including MACE, all-cause mortality, cardiac death, nonfatal MI, and TVR