Outcomes According to Coronary Disease Complexity and Optimal Thresholds to Guide Revascularization Approach: FAME 3 Trial
Authors' conclusion
In patients with MVD without left main disease, PCI and CABG outcomes remain comparable up to SS values in the mid- rather than low 20s, which allows the identification of a greater proportion of patients in whom PCI may be a reasonable alternative to CABG.
Study context
- Population
- Patients with multivessel disease (MVD) without left main diseaseof 1,500 in FAME 3
- Participants
- 1,444 patients
- Comparison
- Percutaneous coronary intervention (PCI) vs coronary artery bypass grafting (CABG) by SYNTAX score
- PCIn = 734
- CABGn = 710reference
- Primary endpoint
- Primary endpoint (not specified in the abstract)
- Follow-up
- 3-year
Primary result
As reported in the abstract
3-year primary endpoint, CABG vs PCI by SS · 3 years
Outcomes comparable between CABG and PCI for SYNTAX score (SS) ≤24
P = 0.332
Patients below SS ≤24 threshold
44%
Patients below conventional SS threshold ≤22
32%
Significant interactions between revascularization strategy and SS for 1- and 3-year composite endpoints
P for interaction <0.05 for all
Further findings
Mean SYNTAX score
- Mean SS
- 25.9 ± 7.1
Association of SS with outcomes
- SS associated with 1-year MACCE among PCI patients and 3-year death, MI and stroke among CABG patients
Original publication
Outcomes According to Coronary Disease Complexity and Optimal Thresholds to Guide Revascularization Approach: FAME 3 Trial. JACC Cardiovasc Interv. Published 26 August 2024. doi:10.
Summarised from the published abstract; every number is checked against it