{"id":"594029179c19","type":"article","url":"https://hartvaat.nl/2022/01/13/ffr-geleide-pci-versus-cabg-nejm-fame-3/","title":"FFR-geleide PCI versus CABG: NEJM FAME 3","title_en":"Fractional Flow Reserve-Guided PCI as Compared with Coronary Bypass Surgery.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2112299","source_url":"https://doi.org/10.1056/NEJMoa2112299","authors":["William F Fearon","Frederik M Zimmermann","Bernard De Bruyne","Zsolt Piroth","Albert H M van Straten","Laszlo Szekely","Giedrius Davidavičius","Gintaras Kalinauskas","Samer Mansour","Rajesh Kharbanda","Nikolaos Östlund-Papadogeorgos","Adel Aminian","Keith G Oldroyd","Nawwar Al-Attar","Nikola Jagic","Jan-Henk E Dambrink","Petr Kala","Oskar Angerås","Philip MacCarthy","Olaf Wendler","Filip Casselman","Nils Witt","Kreton Mavromatis","Steven E S Miner","Jaydeep Sarma","Thomas Engstrøm","Evald H Christiansen","Pim A L Tonino","Michael J Reardon","Di Lu","Victoria Y Ding","Yuhei Kobayashi","Mark A Hlatky","Kenneth W Mahaffey","Manisha Desai","Y Joseph Woo","Alan C Yeung","Nico H J Pijls"],"significance":9,"published":"2022-01-13","source_date":"2022-01-13","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/dubbele-antistolling-indicaties/"],"congress":"","summary_en":"The FAME 3 trial showed that FFR-guided PCI was not noninferior to CABG for the composite of death, MI, stroke, or repeat revascularization at 1 year in patients with three-vessel coronary artery disease. The result reinforced CABG as the preferred strategy for extensive multivessel disease.","created":"2026-07-03T10:29:35Z","updated":"2026-07-03T13:28:43Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"NEJM FAME 3 trial die FFR-geleide PCI vergeleek met CABG bij drievatencoronairlijden. PCI niet non-inferieur aan CABG — bevestigt CABG-voorkeur bij uitgebreid coronairlijden.","abstract_original":"BACKGROUND: Patients with three-vessel coronary artery disease have been found to have better outcomes with coronary-artery bypass grafting (CABG) than with percutaneous coronary intervention (PCI), but studies in which PCI is guided by measurement of fractional flow reserve (FFR) have been lacking. METHODS: 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. Noninferiority of FFR-guided PCI to CABG was prespecified as an upper boundary of less than 1.65 for the 95% confidence interval of the hazard ratio. Secondary end points included a composite of death, myocardial infarction, or stroke; safety was also assessed. RESULTS: A total of 1500 patients underwent randomization at 48 centers. Patients assigned to undergo PCI received a mean (±SD) of 3.7±1.9 stents, and those assigned to undergo CABG received 3.4±1.0 distal anastomoses. The 1-year incidence of the composite primary end point was 10.6% among patients randomly assigned to undergo FFR-guided PCI and 6.9% among those assigned to undergo CABG (hazard ratio, 1.5; 95% confidence interval [CI], 1.1 to 2.2), findings that were not consistent with noninferiority of FFR-guided PCI (P = 0.35 for noninferiority). The incidence of death, myocardial infarction, or stroke was 7.3% in the FFR-guided PCI group and 5.2% in the CABG group (hazard ratio, 1.4; 95% CI, 0.9 to 2.1). The incidences of major bleeding, arrhythmia, and acute kidney injury were higher in the CABG group than in the FFR-guided PCI group. CONCLUSIONS: In patients with three-vessel coronary artery disease, FFR-guided PCI was not found to be noninferior to CABG with respect to the incidence of a composite of death, myocardial infarction, stroke, or repeat revascularization at 1 year. (Funded by Medtronic and Abbott Vascular; FAME 3 ClinicalTrials.gov number, NCT02100722.)."}