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Mid-term clinical outcomes of FFRangio guided treatment for coronary artery disease: Insights from an international multicentre registry.

Mid-term clinical outcomes of FFRangio guided treatment for coronary artery disease: Insights from an international multicentre registry. Cardiovascular revascularization medicine : including molecular interventions Witberg, G., Kikuta, Y., Dan, K., Matsumura, M., Maehara, A., Tanigaki, T., Yokoi, H., Hikichi, Y., Nanasato, M., Miura, K., Sato, K., Taniguchi, M., Goto, K., Haruta, S., Levi, A., Otake, H., Fearon, W. F., Matsuo, H., Kornowski, R., Takebayashi, H. 2026

Abstract

BACKGROUND: Wire-based fractional flow reserve (wbFFR) is the gold standard for physiologic assessment of coronary artery disease (CAD). Recently, angiogram-based FFRangio have shown good diagnostic performance against wbFFR. Limited outcome data is available for FFRangio. The present study aimed to investigate the clinical outcomes of FFRangio-guided treatment for CAD in real-world practice.METHODS: In an international multicentre registry, CAD patients assessed using FFRangio underwent angiography/revascularisation at 7 centres. The primary endpoint was 1-year cumulative incidence of cardiovascular death/myocardial infarction (MI)/unplanned revascularisation (UR).RESULTS: Our cohort included 2129 lesions from 1579 patients. In 1951 lesions (91.6%) and 1435 patients (90.9%), treatment was concordant with FFRangio results. Mean age was 70.3years and 30.6% were female. Mean FFRangio was 0.86 (0.66 and 0.95 in the revascularised and deferred lesions, respectively). After a median follow up of 365 (Q1-Q3: 326-365) days, the primary endpoint for the revascularisation and deferral groups was 6.8% and 1.6% (cardiovascular death 0% and 0.4%, MI 1.0% and 0.1%, UR 6.8% and 1.2%). Risk for the primary endpoint was 3.6% and 8.7% in the concordant and discordant groups, respectively (adjusted HR 0.38 [95%CI: 0.19-0.88], p=0.006), driven by lower incidence of event in the concordant revascularisation vs. discordant deferral groups (6.8 vs. 12.3%, HR 0.43 [95%CI: 0.19-0.95], p=0.038).CONCLUSIONS: In real-world setting, FFRangio-guided treatment yields excellent one-year outcomes for both revascularisation and deferred lesion, which are comparable with current data for wbFFR-guided treatment. FFRangio-concordant revascularisation was associated with better prognosis than FFRangio-discordant deferral for patients with FFRangio=0.8.TRIAL REGISTRATION: NCT05648396.

View details for DOI 10.1016/j.carrev.2026.01.012

View details for PubMedID 41620337