ZIMMERMANN, Frederik M, Victoria Y DING, Nico H J PIJLS, Zsolt PIROTH, Albert H M VAN STRATEN, Laszlo SZEKELY, Giedrius DAVIDAVICIUS, Gintaras KALINAUSKAS, Samer MANSOUR, Rajesh KHARBANDA, Nikolaos OSTLUND-PAPADOGEORGOS, Adel AMINIAN, Keith G OLDROYD, Nawwar AL-ATTAR, Nikola JAGIC, Jan-Henk E DAMBRINK, Petr KALA, Oskar ANGERAS, Philip MACCARTHY, Olaf WENDLER, Filip CASSELMAN, Nils WITT, Kreton MAVROMATIS, Steven E S MINER, Jaydeep SARMA, Thomas ENGSTROM, Evald H CHRISTIANSEN, Pim A L TONINO, Michael J REARDON, Hisao OTSUKI, Yuhei KOBAYASHI, Mark A HLATKY, Kenneth W MAHAFFEY, Manisha DESAI, Y Joseph WOO, Alan C YEUNG, De Bruyne BERNARD and William F FEARON. Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial. Circulation. Philadelphia: Lippincott Williams Wilkins, 2023, vol. 148, No 12, p. 950-958. ISSN 0009-7322. Available from: https://dx.doi.org/10.1161/CIRCULATIONAHA.123.065770.
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Basic information
Original name Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial
Authors ZIMMERMANN, Frederik M, Victoria Y DING, Nico H J PIJLS, Zsolt PIROTH, Albert H M VAN STRATEN, Laszlo SZEKELY, Giedrius DAVIDAVICIUS, Gintaras KALINAUSKAS, Samer MANSOUR, Rajesh KHARBANDA, Nikolaos OSTLUND-PAPADOGEORGOS, Adel AMINIAN, Keith G OLDROYD, Nawwar AL-ATTAR, Nikola JAGIC, Jan-Henk E DAMBRINK, Petr KALA (203 Czech Republic, belonging to the institution), Oskar ANGERAS, Philip MACCARTHY, Olaf WENDLER, Filip CASSELMAN, Nils WITT, Kreton MAVROMATIS, Steven E S MINER, Jaydeep SARMA, Thomas ENGSTROM, Evald H CHRISTIANSEN, Pim A L TONINO, Michael J REARDON, Hisao OTSUKI, Yuhei KOBAYASHI, Mark A HLATKY, Kenneth W MAHAFFEY, Manisha DESAI, Y Joseph WOO, Alan C YEUNG, De Bruyne BERNARD and William F FEARON.
Edition Circulation, Philadelphia, Lippincott Williams Wilkins, 2023, 0009-7322.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30201 Cardiac and Cardiovascular systems
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 37.800 in 2022
RIV identification code RIV/00216224:14110/23:00133683
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1161/CIRCULATIONAHA.123.065770
UT WoS 001078473500004
Keywords in English coronary artery bypass; drug-eluting stents; percutaneous coronary intervention
Tags 14110211, rivok
Tags International impact, Reviewed
Changed by Changed by: Mgr. Tereza Miškechová, učo 341652. Changed: 29/2/2024 08:28.
Abstract
BACKGROUND: Previous studies comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) in patients with multivessel coronary disease not involving the left main have shown significantly lower rates of death, myocardial infarction (MI), or stroke after CABG. These studies did not routinely use current-generation drug-eluting stents or fractional flow reserve (FFR) to guide PCI. METHODS: FAME 3 (Fractional Flow Reserve versus Angiography for Multivessel Evaluation) is an investigator-initiated, multicenter, international, randomized trial involving patients with 3-vessel coronary artery disease (not involving the left main coronary artery) in 48 centers worldwide. Patients were randomly assigned to receive FFR-guided PCI using zotarolimus drug-eluting stents or CABG. The prespecified key secondary end point of the trial reported here is the 3-year incidence of the composite of death, MI, or stroke. RESULTS: A total of 1500 patients were randomized to FFR-guided PCI or CABG. Follow-up was achieved in >96% of patients in both groups. There was no difference in the incidence of the composite of death, MI, or stroke after FFR-guided PCI compared with CABG (12.0% versus 9.2%; hazard ratio [HR], 1.3 [95% CI, 0.98-1.83]; P=0.07). The rates of death (4.1% versus 3.9%; HR, 1.0 [95% CI, 0.6-1.7]; P=0.88) and stroke (1.6% versus 2.0%; HR, 0.8 [95% CI, 0.4-1.7]; P=0.56) were not different. MI occurred more frequently after PCI (7.0% versus 4.2%; HR, 1.7 [95% CI, 1.1-2.7]; P=0.02). CONCLUSIONS: At 3-year follow-up, there was no difference in the incidence of the composite of death, MI, or stroke after FFR-guided PCI with current-generation drug-eluting stents compared with CABG. There was a higher incidence of MI after PCI compared with CABG, with no difference in death or stroke. These results provide contemporary data to allow improved shared decision-making between physicians and patients with 3-vessel coronary artery disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02100722.
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