Iannaccone M, Abdirashid M, Annone U, et al. - In order to define the optimal approach to guide percutaneous coronary intervention (PCI), researchers analyzed randomized controlled trials and propensity score weight-matched studies comparing functional driven (fractional flow reserve) vs intravascular imaging (intravascular ultrasound, and/or optical coherence tomography) vs standard (coronary angiography only)-guided PCI, with a focus on major adverse cardiovascular event (a composite endpoint of death or myocardial infarction or revascularization), considered the primary endpoint. As far as clinical outcomes were concerned, the observed performance of functional and intravascular imaging methods appeared comparable, and were both better vs the standard method. In acute coronary syndrome patients, imaging was found to be potentially beneficial. The requirement for broader use of functional or imaging driven PCI was emphasized by the findings.