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Fractional Flow Reserve-Guided PCI or Coronary Bypass Surgery for 3-Vessel Coronary Artery Disease: 3-Year Follow-Up of the FAME 3 Trial
FM. Zimmermann, VY. Ding, NHJ. Pijls, Z. Piroth, AHM. van Straten, L. Szekely, G. Davidavicius, G. Kalinauskas, S. Mansour, R. Kharbanda, N. Östlund-Papadogeorgos, A. Aminian, KG. Oldroyd, N. Al-Attar, N. Jagic, JE. Dambrink, P. Kala, O. Angeras,...
Jazyk angličtina Země Spojené státy americké
Typ dokumentu randomizované kontrolované studie, multicentrická studie, časopisecké články, práce podpořená grantem
NLK
Free Medical Journals
od 1950 do Před 1 rokem
Open Access Digital Library
od 1950-01-01
Open Access Digital Library
od 1950-01-01
- MeSH
- cévní mozková příhoda * epidemiologie etiologie MeSH
- frakční průtoková rezerva myokardu * MeSH
- infarkt myokardu * MeSH
- koronární angioplastika * škodlivé účinky MeSH
- koronární bypass škodlivé účinky MeSH
- lidé MeSH
- následné studie MeSH
- nemoci koronárních tepen * chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
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.
Aarhus University Hospital Denmark
Atlanta VA Healthcare System Decatur GA
Cardiovascular Center Aalst Belgium
Catharina Hospital Eindhoven the Netherlands
Centre Hospitalier de l'Université de Montréal Canada
Centre Hospitalier Universitaire de Charleroi Belgium
Clinic of Cardiac and Vascular Diseases Institute of Clinical Medicine Vilnius University Lithuania
Clinical Hospital Centre Zemun University of Belgrade Serbia
Danderyd University Hospital and Karolinska Institutet Solna Sweden
Department of Cardiothoracic Surgery Stanford University CA
Departments of Health Policy and Medicine Stanford University CA
Division of Cardiovascular Medicine and Stanford Cardiovascular Institute Stanford University CA
Emory University School of Medicine Atlanta GA
Golden Jubilee National Hospital Glasgow UK
Gottsegen National Cardiovascular Center Hungary
Isala Hospital Zwolle the Netherlands
Karolinska Institutet Solna Sweden
Kings College Hospital London UK
Lausanne University Centre Hospital Switzerland
Medical Faculty of Masaryk University and University Hospital Brno Czech Republic
New York Presbyterian Brooklyn Methodist and Weill Cornell Medical College
Oxford University Hospital NHS Trust UK
Quantitative Sciences Unit Stanford University CA
Rigshospitalet Copenhagen Denmark
Sahlgrenska University Hospital Sweden
Södersjukhuset Hospital Stockholm Sweden
Southlake Regional Health Centre Newmarket Canada
VA Palo Alto Health Care System CA
Citace poskytuje Crossref.org
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