Coronary disease & ACSRandomised controlled trial
Outcomes after fractional flow reserve-guided percutaneous coronary intervention versus coronary artery bypass grafting (FAME 3): 5-year follow-up of a multicentre, open-label, randomised trial
- Randomised controlled trial
- multicentre
- open-label
- 5-year follow-up
- final prespecified analysis
- 5-year follow-up in 724 (96%) percutaneous coronary intervention (PCI) and 696 (94%) coronary artery bypass grafting (CABG)
Authors' conclusion
At the 5-year follow-up, there was no significant difference in a composite outcome of death, stroke, or myocardial infarction after FFR-guided PCI versus CABG, although myocardial infarction and repeat revascularisation were higher with PCI.
Study context
- Population
- Patients with three-vessel CAD not involving the left main coronary artery; 48 hospitals in Europe, USA and Canada, Australia and Asia
- Participants
- 1,500 patients
- Comparison
- Fractional Flow Reserve (FFR)-guided PCI vs CABG
- PCIn = 757
- CABGn = 743reference
- Primary endpoint
- Composite of:
- Death
- Stroke
- MI
- Follow-up
- 5 years
Primary result
Death, stroke or MI
Hazard ratio
1.16
95% CI 0.89–1.52
P = 0.27
Events by treatment group
PCI vs CABG
HR 1.16 (95% CI 0.89–1.52); P = 0.27
As reported in the abstract
Further findings
Death · 5 years
0.99 (CI 0.67–1.46)
Stroke · 5 years
0.65 (CI 0.33–1.28)
MI · 5 years · higher with PCI
1.57 (CI 1.04–2.36)
Repeat revascularisation · 5 years · higher with PCI
2.02 (CI 1.46–2.79)
Original publication
Outcomes after fractional flow reserve-guided percutaneous coronary intervention versus coronary artery bypass grafting (FAME 3): 5-year follow-up of a multicentre, open-label, randomised trial. Lancet. Published 30 March 2025. doi:10.1016/s0140-6736(25)00505-7
Summarised from the published abstract; every number is checked against it