{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:56Z","timestamp":1789535096034,"version":"build-2803163510"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The diagnostic performance of fractional flow reserve (FFR) in the setting of acute coronary syndrome (ACS) remains unclear. We sought to perform an updated systematic review and meta\u2010analysis investigating the performance of FFR\u2010guided revascularization in the setting of ACS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Two main primary comparisons tested the major adverse cardiac events (MACE) rate at 1\u2010year of patients treated with an FFR\u2010guided strategy in ACS versus chronic coronary syndrome and an FFR\u2010guided versus angiographic\u2010guided strategy in acute coronary syndrome. Treatment effect was defined as the risk difference and was estimated with Bayesian random effect model with a conservative prior of no treatment effect. Kaplan\u2013Meier estimates and their standard deviations were retrieved to maximum accuracy from cumulative incidence function\/ survival function plots for studies with censoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">We found 11 eligible trials (with a total of 13\u2009029 patients) in this systematic review. Within the FFR\u2010guided strategy, acute coronary syndrome was associated with an increased risk of MACE at 1\u2009year compared with chronic coronary syndrome (risk difference (RD): 1.9%, 95% credible interval [0.2% to 3.6%]). In contrast, among patients with ACS no difference in 1\u2010year MACE rate was observed between angiography\u2010guided versus FFR\u2010guided complete revascularization strategy (RD=0.9%, 95% CI [\u22121.3 to 3.2]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">FFR\u2010guided strategy of lesions in acute coronary syndrome was associated with worse 1\u2010year MACE compared with FFR\u2010guided revascularization in chronic coronary syndrome reflecting the high\u2010risk nature of acute coronary syndrome patients. No difference in long\u2010term outcomes was seen from a FFR\u2010guided versus angiography\u2010guided approach in acute coronary syndrome. Further studies are needed to better understand and optimize the use of physiology in the ACS setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.050265","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T14:50:31Z","timestamp":1788965431000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Fractional Flow Reserve in Acute Coronary Syndrome: An Updated Systematic Review and Bayesian Meta\u2010Analysis"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4904-0049","authenticated-orcid":false,"given":"Edward T.","family":"Ha","sequence":"first","affiliation":[{"name":"Medstar Washington Hospital Center","place":["Washington, 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Hospital Center","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beni","family":"Verma","sequence":"additional","affiliation":[{"name":"Medstar Washington Hospital Center","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6058-232X","authenticated-orcid":false,"given":"Yuhei","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"NewYork\u2010Presbyterian Brooklyn Methodist Hospital","place":["Brooklyn, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4063-9226","authenticated-orcid":false,"given":"Ron","family":"Waksman","sequence":"additional","affiliation":[{"name":"Medstar Washington Hospital Center","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5100-0471","authenticated-orcid":false,"given":"H\u00e9ctor M.","family":"Garc\u00eda\u2010Garc\u00eda","sequence":"additional","affiliation":[{"name":"Medstar Washington Hospital Center","place":["Washington, 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