{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:33:01Z","timestamp":1792787581559,"version":"4.5.0"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MOST | National Natural Science Foundation of China","id":[{"id":"https:\/\/ror.org\/01h0zpd94","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Ministry of Trade, Industry and Energy","award":["RS-2024-00444631"],"award-info":[{"award-number":["RS-2024-00444631"]}],"id":[{"id":"https:\/\/ror.org\/008nkqk13","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Ministry of Food and Drug Safety","award":["RS-2023-00215667"],"award-info":[{"award-number":["RS-2023-00215667"]}],"id":[{"id":"https:\/\/ror.org\/01f7dp456","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,9]]},"abstract":"\n BACKGROUND:<\/jats:title>\n While angiography-derived fractional flow reserve (AngioFFR)- and intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) yield similar outcomes, with AngioFFR associated with lower PCI rates, the relative clinical effectiveness of AngioFFR versus IVUS-guided PCI according to angiographic lesion characteristics remains unclear.<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n This post hoc analysis of the FLAVOUR II trial (Comparison of Angiography-Derived Fractional Flow Reserve- and Intravascular Ultrasound-Guided Intervention Strategy for Clinical Outcomes in Patients with Coronary Artery Disease) included patients with \u226550% stenosis randomized to AngioFFR- or IVUS-guided PCI. A composite lesion risk score was derived using a marginal Cox model-based linear predictor incorporating % diameter stenosis, lesion length, true bifurcation, ostial lesion, and heavy calcification. The primary end point was target vessel failure (TVF: cardiac death, target vessel myocardial infarction, and target vessel revascularization).<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n \n Among 1726 patients, 884 (51.2%) underwent AngioFFR-guided PCI and 842 (48.8%) underwent IVUS-guided PCI. During a median 12-month follow-up, TVF occurred in 2.4% of AngioFFR-treated vessels and 1.9% of IVUS-treated vessels (\n P<\/jats:italic>\n =0.50). TVF risk increased progressively with a higher composite lesion risk score (adjusted hazard ratio, 2.76 [95% CI, 1.35\u20135.65]). This association was more pronounced in the AngioFFR group (adjusted hazard ratio, 3.93 [95% CI, 1.79\u20138.63]) than in the IVUS group (adjusted hazard ratio, 1.62 [95% CI, 0.42\u20136.22]). Compared with IVUS guidance, AngioFFR-guided vessels with high-risk lesions (score >0.32) had a higher TVF rate (5.1% versus 1.9%;\n P<\/jats:italic>\n =0.010), whereas outcomes were comparable in those with low-risk lesions (1.5% versus 1.9%;\n P<\/jats:italic>\n =0.531). AngioFFR guidance was associated with lower target vessel PCI rates in low-risk lesions (60.1% versus 76.5%;\n P<\/jats:italic>\n <0.001), whereas PCI rates were uniformly high and similar between groups in high-risk lesions (96.4% versus 97.4%;\n P<\/jats:italic>\n =0.675).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n A higher composite lesion risk score was associated with increased PCI rates and TVF risk after AngioFFR- or IVUS-guided treatment. AngioFFR guidance was associated with lower PCI rates in low-risk lesions, whereas IVUS guidance may yield more favorable outcomes in high-risk lesions.<\/jats:p>\n <\/jats:sec>\n \n REGISTRATION:<\/jats:title>\n \n URL:\n https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n ; Unique identifier: NCT04397211.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/circinterventions.126.016809","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:00:07Z","timestamp":1779184807000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Angiography-Derived FFR Versus IVUS to Guide PCI According to Angiographic Lesion Characteristics"],"prefix":"10.1161","volume":"19","clinical-trial-number":[{"clinical-trial-number":"nct04397211","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-3930","authenticated-orcid":true,"given":"Seokhun","family":"Yang","sequence":"first","affiliation":[{"name":"Seoul National University Hospital, Republic of Korea (S.Y., J.-E.S., B.-K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyang","family":"Hu","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Transvascular Implantation Devices Research Institute, Hangzhou, China (X.H., J.Z., J.J., J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-5087","authenticated-orcid":true,"given":"Jinlong","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Transvascular Implantation Devices Research Institute, Hangzhou, China (X.H., J.Z., J.J., J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5939-9912","authenticated-orcid":true,"given":"Jin-Eun","family":"Song","sequence":"additional","affiliation":[{"name":"Seoul National University Hospital, Republic of Korea (S.Y., J.-E.S., B.-K.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6926-9516","authenticated-orcid":true,"given":"Jun","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Zhejiang University School of Medicine, State Key Laboratory of Transvascular Implantation Devices, Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Transvascular Implantation Devices Research Institute, Hangzhou, China (X.H., J.Z., J.J., J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoping","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Nanchang University, Jiangxi Hypertension Research Institute, China (X.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongsheng","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Changxing People\u2019s Hospital, Huzhou, China (D.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibin","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jinhua Central Hospital, China (Y.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, Beijing, China (L.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3312-5478","authenticated-orcid":true,"given":"Jilin","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Second Affiliated Hospital of Shantou University Medical College, China (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6018-437X","authenticated-orcid":true,"given":"Wenming","family":"He","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Ningbo University, China (W.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the First Affiliated Hospital of Wenzhou Medical University, China (H.Z.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0618-9388","authenticated-orcid":true,"given":"Jun","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, China (J.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4993-3197","authenticated-orcid":true,"given":"Jinyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hangzhou First People\u2019s Hospital, China (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Affiliated Hospital of Hangzhou Normal University, China (F.J.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4089-7006","authenticated-orcid":true,"given":"Qiang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, the Fourth People\u2019s Hospital of Jinan, China (Q.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daqing","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Jining 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