FAME 3
Fractional flow reserve versus Angiography for Multivessel Evaluation 3
Patient / Population Intervention / Exposure Comparison Outcome
In 1,500 patients with 3-vessel coronary disease, FFR-guided PCI did not prove non-inferior for 1-year death, MI, stroke, or repeat revascularisation compared with CABG.
N
1,500
Design
Multicentre RCT, non-inferiority
Endpoint
MACCE (death, MI, stroke, or repeat revascularisation) at 1 year
Relevance
2
ResultFFR-guided PCI 10.6% vs CABG 6.9% (HR 1.5, 95% CI 1.1-2.2); non-inferiority not met. At 5 years death/stroke/MI similar (16% vs 14%, HR 1.16, 95% CI 0.89-1.52).
Fearon WF, et al. N Engl J Med. 2022;386(2):128-37. 10.1056/NEJMoa2112299
Discussion & critique
1-year timepoint is short for a surgery-vs-PCI comparison and differences narrowed by 5 years. Reinforced CABG as preferred for higher-complexity 3-vessel disease while supporting PCI in lower SYNTAX-score anatomy.