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CORONARY ARTERY DISEASE

Enduring FAME of FFR-guided PCI

Nature Reviews Cardiology volume 15, page 442 (2018)Cite this article

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Patients with stable coronary artery disease (CAD) and a fractional flow reserve (FFR) ≤0.80 benefit from revascularization plus medical therapy, whereas those with an FFR >0.80 have a favourable outcome with medical therapy only. These 5-year outcomes of the FAME 2 trial were presented at the EuroPCR conference in Paris, France, and simultaneously published in NEJM.

A total of 888 patients with an FFR ≤0.80 were randomly assigned to percutaneous coronary intervention (PCI) plus medical therapy or to medical therapy only. Patients with an FFR >0.80 received medical therapy only and were entered into a registry. After 5 years of follow-up, the rate of the primary end point (a composite of death, myocardial infarction, or urgent revascularization) was lower in the PCI group than in the medical-therapy group (13.9% versus 27.0%; HR 0.46, 95% CI 0.34–0.64). This difference was driven by a lower rate of urgent revascularization in the PCI group (6.3% versus 21.1%; HR 0.27, 95% CI 0.18–0.41). Of note, PCI was also associated with a lower rate of spontaneous myocardial infarction (6.5% versus 10.2%; HR 0.62, 95% CI 0.39–0.99). By contrast, mortality was similar in the two groups (5.1% versus 5.2%). The rate of the primary end point was not significantly different in the group undergoing PCI compared with the registry cohort (13.9% versus 15.7%).

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  1. Nature Reviews Cardiology http://www.nature.com/nrcardio/

    Gregory B. Lim

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  1. Gregory B. Lim
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Correspondence to Gregory B. Lim.

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Lim, G.B. Enduring FAME of FFR-guided PCI. Nat Rev Cardiol 15, 442 (2018). https://doi.org/10.1038/s41569-018-0041-9

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