FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Diabetes
Authors' conclusion
In this subgroup analysis of the FAME 3 randomized clinical trial, the relative benefit of CABG compared with FFR-guided PCI was similar among patients with and without diabetes.
Study context
- Population
- Patients with 3-vessel CAD not involving the left main undergoing revascularization, 2014–2019428 with diabetes
- Participants
- 1,500 patients
- Comparison
- Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) vs CABG, by diabetes status
- Primary endpoint
- MACCE:
- All-cause death
- MI
- Stroke
- Repeat revascularization
- Follow-up
- 3 years
Methodological detailsprespecified subgroup analysis, investigator-initiated, 48 centres worldwide
- Prespecified subgroup analysis
- Investigator-initiated
- 48 centres worldwide
Primary result
As reported in the abstract
MACCE by diabetes status
PCI vs CABGHazard ratio (95% CI)P value
Diabetes
1.44(0.91–2.28)
P = 0.12No diabetes
1.50(1.08–2.07)
P = 0.02Further findings
Major adverse cardiac and cerebrovascular events (MACCE) by SYNTAX score
- Low SYNTAX score (<23): no significant difference in MACCE between PCI and CABG
- Intermediate to high SYNTAX score (≥23): higher MACCE risk with PCI than CABG, regardless of diabetes status
MACCE, diabetes vs no diabetes · 3 years
- Higher MACCE risk with diabetes, especially insulin-treated
Original publication
FFR-Guided Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Diabetes. JAMA Cardiol. Published 1 June 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →