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Fractional Flow Reserve–Guided PCI as Compared with Coronary Bypass Surgery

Friday, November 5, 2021

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Source Name: The New England Journal of Medicine


William F. Fearon, M.D., Frederik M. Zimmermann, M.D., Bernard De Bruyne, M.D., Ph.D., Zsolt Piroth, M.D., Ph.D., Albert H.M. van Straten, M.D., Ph.D., Laszlo Szekely, M.D., Giedrius Davidavičius, M.D., Ph.D., Gintaras Kalinauskas, M.D., Ph.D., Samer Mansour, M.D., Rajesh Kharbanda, Ph.D., Nikolaos Östlund-Papadogeorgos, M.D., Adel Aminian, M.D., Keith G. Oldroyd, M.D., Nawwar Al-Attar, M.D., Ph.D., Nikola Jagic, M.D., Ph.D., Jan-Henk E. Dambrink, M.D., Ph.D., Petr Kala, M.D., Ph.D., Oskar Angerås, M.D., Ph.D., Philip MacCarthy, Ph.D., F.R.C.P., Olaf Wendler, M.D., Ph.D., Filip Casselman, M.D., Ph.D., Nils Witt, M.D., Ph.D., Kreton Mavromatis, M.D., Steven E.S. Miner, M.D., Jaydeep Sarma, Ph.D., F.R.C.P., Thomas Engstrøm, Ph.D., D.M.Sci., Evald H. Christiansen, M.D., Ph.D., Pim A.L. Tonino, M.D., Ph.D., Michael J. Reardon, M.D., Di Lu, M.S., Victoria Y. Ding, M.S., Yuhei Kobayashi, M.D., Mark A. Hlatky, M.D., Kenneth W. Mahaffey, M.D., Manisha Desai, Ph.D., Y. Joseph Woo, M.D., Alan C. Yeung, M.D., and Nico H.J. Pijls, M.D., Ph.D. for the FAME 3 Investigators

Patients with three-vessel coronary artery disease have been known to have better outcomes with coronary-artery bypass grafting (CABG) than patients with percutaneous coronary intervention (PCI). However, studies in which PCI is guided by measurement of fractional flow reserve (FFR) have been lacking.

In this multicenter, international, noninferiority trial, patients with three-vessel coronary artery disease were randomly assigned to undergo CABG or FFR-guided PCI with current-generation zotarolimus-eluting stents. The primary end point was the occurrence within 1 year of a major adverse cardiac or cerebrovascular event, defined as death from any cause, myocardial infarction, stroke, or repeat revascularization.

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