Outcomes After Coronary Artery Bypass Grafting (CABG) Compared With FFR-Guided Percutaneous Coronary Intervention (PCI) in Patients Presenting With Acute Coronary Syndrome
Authors' conclusion
The risk of death, MI, or stroke at 3 years was similar after CABG compared with FFR-guided PCI in patients presenting with NSTE-ACS, but reduced by CABG in patients presenting with CCS.
Study context
- Population
- Patients with 3-vessel CAD, presenting with NSTE-ACS (587 [39.2%]) or chronic coronary syndrome (CCS)587 (39.2%) NSTE-ACS
- Participants
- 1,500 patients
- Comparison
- CABG vs fractional flow reserve (FFR)-guided PCI, in patients with vs without NSTE-ACS
- Primary endpoint
- Death, MI or stroke (key secondary endpoint of FAME 3), by NSTE-ACS vs CCS presentation
- Follow-up
- 3 years
Methodological detailsinvestigator-initiated, subgroup analysis by NSTE-ACS vs CCS presentation, Median follow-up 1,080 days (Q1-Q3: 1,080-1,080 days)
- Investigator-initiated
- Subgroup analysis by NSTE-ACS vs CCS presentation
- Median follow-up 1,080 days (Q1-Q3: 1,080-1,080 days)
Primary result
As reported in the abstract
Death, MI or stroke, CABG vs PCI, by presentation
CABG vs PCIAdjusted hazard ratio (95% CI)P value
NSTE-ACS
0.98(0.60–1.60)
P = 0.94CCS
0.58(0.38–0.90)
P = 0.02Secondary outcomes
| Outcome | NSTE-ACS | CCS | aHR (95% CI) | P value | |
|---|---|---|---|---|---|
| Death, MI or stroke, NSTE-ACS vs CCS presentation · 3 years | 11.8% | 10.0% | 1.20 (0.81–1.77) | P = 0.37 | |
| MI, CABG vs PCI (CCS subgroup) · 3 yearsCCS | 0.32 (0.15–0.64) | P = 0.002 | |||
| 0.10.31310Adjusted hazard ratio (log scale) |
- Myocardial infarction (MI), CABG vs PCI (CCS subgroup): interaction P = 0.01
Original publication
Outcomes After CABG Compared With FFR-Guided PCI in Patients Presenting With Acute Coronary Syndrome. JACC Cardiovasc Interv. Published 14 April 2025. doi:10.
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