Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery
for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the
FAME 3 Trial

J 2023

Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial

ZIMMERMANN, Frederik M, Victoria Y DING, Nico H J PIJLS, Zsolt PIROTH, Albert H M VAN STRATEN et. al.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

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

Abstract

V originále

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.

Citovat

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.

@article{2379802,
   author = {Zimmermann, Frederik M and Ding, Victoria Y and Pijls, Nico H J and Piroth, Zsolt and van Straten, Albert H M and Szekely, Laszlo and Davidavicius, Giedrius and Kalinauskas, Gintaras and Mansour, Samer and Kharbanda, Rajesh and OstlundandPapadogeorgos, Nikolaos and Aminian, Adel and Oldroyd, Keith G and AlandAttar, Nawwar and Jagic, Nikola and Dambrink, JanandHenk E and Kala, Petr and Angeras, Oskar and MacCarthy, Philip and Wendler, Olaf and Casselman, Filip and Witt, Nils and Mavromatis, Kreton and Miner, Steven E S and Sarma, Jaydeep and Engstrom, Thomas and Christiansen, Evald H and Tonino, Pim A L and Reardon, Michael J and Otsuki, Hisao and Kobayashi, Yuhei and Hlatky, Mark A and Mahaffey, Kenneth W and Desai, Manisha and Woo, Y Joseph and Yeung, Alan C and Bernard, De Bruyne and Fearon, William F},
   article_location = {Philadelphia},
   article_number = {12},
   doi = {http://dx.doi.org/10.1161/CIRCULATIONAHA.123.065770},
   keywords = {coronary artery bypass; drug-eluting stents; percutaneous coronary intervention},
   language = {eng},
   issn = {0009-7322},
   journal = {Circulation},
   title = {Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial},
   url = {https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065770},
   volume = {148},
   year = {2023}
}

TY  - JOUR
ID  - 2379802
AU  - Zimmermann, Frederik M - Ding, Victoria Y - Pijls, Nico H J - Piroth, Zsolt - van Straten, Albert H M - Szekely, Laszlo - Davidavicius, Giedrius - Kalinauskas, Gintaras - Mansour, Samer - Kharbanda, Rajesh - Ostlund-Papadogeorgos, Nikolaos - Aminian, Adel - Oldroyd, Keith G - Al-Attar, Nawwar - Jagic, Nikola - Dambrink, Jan-Henk E - Kala, Petr - Angeras, Oskar - MacCarthy, Philip - Wendler, Olaf - Casselman, Filip - Witt, Nils - Mavromatis, Kreton - Miner, Steven E S - Sarma, Jaydeep - Engstrom, Thomas - Christiansen, Evald H - Tonino, Pim A L - Reardon, Michael J - Otsuki, Hisao - Kobayashi, Yuhei - Hlatky, Mark A - Mahaffey, Kenneth W - Desai, Manisha - Woo, Y Joseph - Yeung, Alan C - Bernard, De Bruyne - Fearon, William F
PY  - 2023
TI  - Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial
JF  - Circulation
VL  - 148
IS  - 12
SP  - 950-958
EP  - 950-958
PB  - Lippincott Williams Wilkins
SN  - 00097322
KW  - coronary artery bypass
KW  - drug-eluting stents
KW  - percutaneous coronary intervention
UR  - https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.123.065770
N2  - 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.
ER  -

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. \textit{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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