{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:57:18Z","timestamp":1781672238224,"version":"3.54.5"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T00:00:00Z","timestamp":1781654400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Invasive fractional flow reserve (FFR) is currently regarded as a reference standard for the functional assessment of intermediate coronary lesions; however, stress perfusion cardiac magnetic resonance (CMR) offers a non-invasive alternative that potentially streamlines clinical decision-making. Evidence comparing the real-world clinical effectiveness and economic implications of these two modalities, particularly within resource-constrained healthcare environments, remains sparse. This study sought to evaluate whether a CMR-guided strategy could reduce revascularization rates and hospital costs while showing comparable short-term clinical outcomes to an FFR-guided strategy in a real-world matched cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study at a tertiary cardiovascular center in China, screening patients with angiographically intermediate coronary stenosis (40%\u201390% diameter stenosis) evaluated between January 2021 and December 2024. To rigorously control for selection bias inherent in observational data, we implemented a 1:1 propensity score matching (PSM) analysis based on extensive baseline covariates. The primary clinical endpoint was a composite of major adverse cardiovascular events (MACE) at 12 months, defined as cardiac death, non-fatal myocardial infarction, or ischemia-driven target vessel revascularization. Secondary endpoints included procedural efficiency, contrast volume consumption, and total hospitalization costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the final propensity-matched cohort of 240 patients, the CMR-guided strategy was associated with a lower PCI utilization rate than the FFR-guided strategy (34.2% vs. 48.3%; odds ratio 0.55; 95% CI, 0.33 to 0.93;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.036). The CMR group also had lower total hospitalization costs (mean difference, -\u00a59,785.3; 95% CI, -\u00a513,253.4 to -\u00a56,317.3;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001) and lower iodinated contrast volume. At 12 months, MACE occurred in 10.0% of patients in the FFR group and 10.8% in the CMR group, with no statistically significant between-group difference (HR 1.05; 95% CI, 0.48 to 2.30; log-rank\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.902). Exploratory subgroup analyses showed no significant interaction across prespecified subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this matched retrospective cohort, CMR-guided management was associated with lower PCI utilization and lower hospitalization costs, while 12-month MACE rates were not significantly different from those observed with FFR-guided management. These findings suggest that CMR-guided evaluation may be a useful gatekeeper approach in selected patients, although confirmation in larger prospective studies is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1808223","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T04:44:54Z","timestamp":1781671494000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Stress cardiac magnetic resonance vs. fractional flow reserve\u2013guided management for intermediate coronary stenosis: a single-center retrospective propensity-matched study with 12-month follow-up"],"prefix":"10.3389","volume":"13","author":[{"given":"Qingru","family":"Meng","sequence":"first","affiliation":[{"name":"Department of Cardiology, Mudanjiang Cardiovascular Hospital","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Yantai Qishan Hospital","place":["Yantai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhendong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mudanjiang Cardiovascular Hospital","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianwei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mudanjiang Cardiovascular Hospital","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mudanjiang Cardiovascular Hospital","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenqi","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Mudanjiang Cardiovascular Hospital","place":["Mudanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihong","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Xinchang County People\u2019s Hospital","place":["Shaoxing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2333","DOI":"10.1161\/01.CIR.92.8.2333","article-title":"Our preoccupation with coronary luminology. 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