Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided Percutaneous Coronary Intervention (PCI) or Coronary Bypass Surgery: A FAME 3 Substudy
Authors' conclusion
The presence of a CTO did not significantly impact the treatment effect of PCI versus CABG at 3 years in patients with 3-vessel coronary artery disease.
Study context
- Population
- Patients with 3-vessel CAD randomised to PCI or coronary artery bypass grafting (CABG) in FAME 3305 (21%) with chronic total occlusion (CTO)
- Comparison
- FFR-guided PCI vs CABG, in patients with vs without CTO
- CTOn = 305
- Primary endpoint
- MACCE:
- Death
- MI
- Stroke
- Repeat revascularization
- Follow-up
- 3 years
Methodological detailssubstudy
- Substudy
Primary result
As reported in the abstract
MACCE, CTO vs no CTO, and PCI vs CABG by CTO status
Adjusted hazard ratio (95% CI)P value
CTO vs No CTOPCI arm: 15.2% vs 20.1%
0.62(0.38–1.03)
P = 0.07CTO vs No CTOCABG arm: 13.0% vs 12.9%
0.96(0.55–1.66)
P = 0.88PCI vs CABGwithout CTO
1.61(1.20–2.17)
P < 0.01PCI vs CABGwith CTO
1.21(0.64–2.28)
P = 0.56Further findings
CTO revascularization in PCI arm
- CTO revascularization attempted
- 61%
- Procedural success rate
- 88%
Original publication
Impact of a Chronic Total Occlusion on Outcomes After FFR-Guided PCI or Coronary Bypass Surgery: A FAME 3 Substudy. Circ Cardiovasc Interv. Published 6 November 2024. doi:10.
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