Liu HR, Weng JL. Interpreting fractional flow reserve-guided percutaneous coronary intervention vs coronary artery bypass grafting outcomes. World J Cardiol 2025; 17(11): 113225 [DOI: 10.4330/wjc.v17.i11.113225]
Corresponding Author of This Article
Heng-Rui Liu, Department of Research, Yinuo Bio company, 1-1204, Shuchang Park, Wanxin Street, Dongli District, Tianjin 061102, China. lh@yinuobiomedical.cn
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Heng-Rui Liu, Department of Research, Yinuo Bio company, Tianjin 061102, China
Jie-Ling Weng, Department of Pathology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Co-corresponding authors: Heng-Rui Liu and Jie-Ling Weng.
Author contributions: Liu HR and Weng JL wrote the paper; they contributed equally to this manuscript and are the corresponding authors.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Heng-Rui Liu, Department of Research, Yinuo Bio company, 1-1204, Shuchang Park, Wanxin Street, Dongli District, Tianjin 061102, China. lh@yinuobiomedical.cn
Received: August 19, 2025 Revised: August 27, 2025 Accepted: October 21, 2025 Published online: November 26, 2025 Processing time: 94 Days and 8.4 Hours
Abstract
Kataveni et al’s meta-analysis offers an important contemporary synthesis of randomized evidence comparing fractional flow reserve-guided percutaneous coronary intervention and coronary artery bypass grafting (CABG) in multivessel coronary artery disease (CAD). The pooled analysis found no significant difference in all-cause mortality or stroke, yet CABG was superior in reducing myocardial infarction, major adverse cardiac events, and repeat revascularization. These results confirm CABG’s durability even in the era of physiological lesion assessment and second-generation drug-eluting stents. From a traditional Chinese medicine (TCM) perspective, multivessel CAD corresponds to syndromes such as “heart vessel obstruction” and “Qi and blood stagnation”, in which local blockage is compounded by systemic imbalance. While revascularization addresses the structural impediment to blood flow, TCM approaches, including herbal medicine, acupuncture, and lifestyle therapy, aim to improve microcirculation, reduce inflammation, and support recovery, potentially mitigating recurrent ischemic events. This commentary argues that future research should integrate optimal revascularization strategies with rigorously evaluated TCM interventions to address both the anatomical and systemic dimensions of CAD and improve long-term patient outcomes.
Core Tip: This commentary highlights that although coronary artery bypass grafting remains superior to fractional flow reserve-guided percutaneous coronary intervention in reducing myocardial infarction and repeat revascularization in multivessel coronary artery disease, optimal outcomes may require an integrative approach. By combining revascularization with evidence-based traditional Chinese medicine to improve systemic vascular health and microcirculation, future strategies could transcend the dichotomy of “surgery vs stenting” and offer more durable, patient-centered benefits.
