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Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Fractional flow reserve-guided PCI as compared with coronary bypass surgery (FAME III)- another brick in the wall!
1Department of Cardiac Surgery; Rabindranath Tagore International Institute of Cardiac Sciences, Narayana Health, 124, EM Bypass, Mukundapur, Kolkata, 700099 India.
Insights
Coronary artery bypass grafting showed better outcomes than fractional flow reserve-guided percutaneous coronary interventions at one year. FFR-guided PCI did not meet noninferiority criteria in the FAME III trial.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Trials
Background:
- Fractional flow reserve (FFR) guides percutaneous coronary interventions (PCI).
- The FAME III trial investigated FFR-guided PCI versus coronary artery bypass grafting (CABG).
Purpose of the Study:
- To compare the efficacy and safety of FFR-guided PCI against CABG.
- To determine if FFR-guided PCI meets noninferiority criteria compared to CABG.
Main Methods:
- Multi-centric randomized controlled trial (FAME III).
- Comparison of FFR-guided PCI with CABG in patients with multi-vessel coronary artery disease.
Main Results:
- CABG demonstrated a significantly lower incidence of the composite endpoint (mortality, stroke, MI, repeat revascularizations) at 1 year compared to FFR-guided PCI.
- FFR-guided PCI failed to meet noninferiority criteria.
Conclusions:
- CABG is associated with superior clinical outcomes compared to FFR-guided PCI at 1 year.
- Current FFR-guided PCI strategies require re-evaluation for patients with multi-vessel coronary artery disease.
Abstract:
FAME III, a multi-centric randomized controlled trial compared fractional flow reserve (FFR) guided percutaneous coronary interventions (PCI) with coronary artery bypass grafting. The study confirmed that compared with FFR-guided-PCI, coronary artery bypass grafting was associated with a significantly lower incidence of the composite of mortality, stroke, MI, and repeat revascularizations at 1 year. Thus, FFR-guided-PCI failed to meet the "noninferiority" criteria.
