Angiography-Based FFR Matches Wire-Guided Outcomes At One-Year
Two randomized trials, ALL-RISE and FAST III, presented at the ACC and published online in the New England Journal of Medicine on March 30, 2026, found angiography-derived fractional flow reserve (FFR) noninferior to pressure wire–guided FFR for 1-year all-cause mortality, MI, or revascularization. Both systems shortened procedural time but led to higher PCI rates (~45% vs ~35%), suggesting wider adoption with caution.
Key Points
- 1Show noninferiority: BOTH trials found angiography-derived FFR comparable to pressure-wire FFR for 1-year clinical outcomes.
- 2Indicate significance: Results strengthen outcome evidence and address prior gaps limiting adoption of angio-based physiology.
- 3Implication: Offers workflow gains but yields ≈10% higher PCI rates; wire confirmation still needed with poor imaging.
Scoring Rationale
High-quality randomized trials published in NEJM and presented at ACC provide strong, industry-wide evidence for angio-derived FFR. Scored high for novelty, scope, actionability, and credibility; modest deductions for applicability across different software and modest coverage depth.
Sources
Public references used for this report.
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