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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Sep 26, 2025; 17(9): 111044
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.111044
Published online Sep 26, 2025. doi: 10.4330/wjc.v17.i9.111044
Fractional flow reserve guided percutaneous coronary intervention vs coronary artery bypass grafting for multivessel coronary artery disease: A meta-analysis
Suhas Kataveni, Shivani Sabarish, Department of Cardiology, Gandhi Medical College, Hyderabad 500001, Telangana, India
Ezza Ellahi, Department of Cardiology, Aziz Fatimah Hospital, Faisalabad 37000, Punjab, Pakistan
Fabeha Zafar, Department of Cardiology, Dow University of Health Sciences, Karachi 75280, Sindh, Pakistan
Ihsan Noushad Karuppan Veettil, Department of Cardiology, Sree Narayana Medical College, Ernakulam 683594, Kerala, India
Amna Iqbal, Department of Cardiology, Wah Medical College, Islamabad 47010, Islamabad, Pakistan
Bhavya Dhir, Department of Cardiology, Government Medical College, Patiala 147001, Punjab, India
Sai Erambalur, Department of Cardiology, Richmond Gabriel University, St. Vincent and Grenadines VCO130, Saint Vincent and the Grenadines
Meenakshi Reddy Yathindra, Department of Cardiology, Kasturba Medical College, Mangalore 575001, Karnataka, India
Moukthika Kvn, Department of Cardiology, Sri Venkateshwara Institute of Medical Sciences, Tirupati 517501, Andhra Pradesh, India
Shayan Nawaz, Department of Cardiology, University College of Medicine & Dentistry, Lahore 54000, Punjab, Pakistan
Satish Kumar Dudekula, Department of Cardiology, University of Perpetual Help System Dalta, Las Piñas CPO 1740, Metro Manila, Philippines
Usman Ul Haq, Department of Medicine, Medway Maritime Hospital NHS Foundation Trust, Gillingham ME7 5NY, United Kingdom
Asraf Hussain, Department of Cardiology, Chitwan Medical College, Bharatpur 33915, Nepal
Muhammad Muneeb Khawar, Department of Cardiology, King Edward Medical University, Lahore 05450, Punjab, Pakistan
Co-first authors: Suhas Kataveni and Ezza Ellahi.
Author contributions: Kataveni S and Ellahi E contribute equally to this study as co-first authors; Kataveni S, Ellahi E, Zafar F, and Veettil INK conceptualized the study; Kataveni S, Iqbal A, Erambalur S, and Yathindra MR designed the methodology; Veettil INK and Dudekula SK handled software; Ellahi E, Sabarish S, and Kvn M performed validation; Zafar F, Iqbal A, and Hussain A conducted formal analysis; Erambalur S, Yathindra MR, Nawaz S, and Dhir B performed investigation; Sabarish S, Kvn M, and Khawar MM provided resources; Nawaz S, Dhir B, and Dudekula SK curated data; Kataveni S, Ellahi E, Zafar F, and Iqbal A wrote the original draft; Karuppan Veettil IN, Erambalur S, Yathindra MR, Sabarish S, Hussain A, and Khawar MM reviewed and edited the manuscript; Ul Haq U and Hussain A prepared visualization; Kataveni S and Karuppan Veettil IN supervised the study; Ellahi E and Kvn M administered the project; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors disclose that they have no conflict of interest related to the subject of this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Asraf Hussain, MD, Department of Cardiology, Chitwan Medical College, Bharatpur-10, Chitwan, Bharatpur 33915, Nepal. drasrafcardiology@gmail.com
Received: June 23, 2025
Revised: July 5, 2025
Accepted: August 15, 2025
Published online: September 26, 2025
Processing time: 87 Days and 22.3 Hours
Revised: July 5, 2025
Accepted: August 15, 2025
Published online: September 26, 2025
Processing time: 87 Days and 22.3 Hours
Core Tip
Core Tip: This meta-analysis compares fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) for multivessel coronary artery disease. While both treatments show similar all-cause mortality and stroke rates, CABG significantly reduces major adverse cardiac events, myocardial infarction, and repeat revascularization. These findings highlight CABG’s superior efficacy in managing complex coronary disease, challenging the broader adoption of FFR-guided PCI. The results underscore the need for tailored treatment strategies and further trials to optimize outcomes in diverse patient populations.