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Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) study.

Abstract The purpose of this study was to investigate the 2-year outcome of percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) in patients with multivessel coronary artery disease (CAD).
PMID
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Authors

Mayor MeshTerms

Coronary Angiography

Drug-Eluting Stents

Keywords
Journal Title journal of the american college of cardiology
Publication Year Start




PMID- 20537493
OWN - NLM
STAT- MEDLINE
DA  - 20100712
DCOM- 20100730
LR  - 20101118
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 56
IP  - 3
DP  - 2010 Jul 13
TI  - Fractional flow reserve versus angiography for guiding percutaneous coronary
      intervention in patients with multivessel coronary artery disease: 2-year
      follow-up of the FAME (Fractional Flow Reserve Versus Angiography for Multivessel
      Evaluation) study.
PG  - 177-84
LID - 10.1016/j.jacc.2010.04.012 [doi]
AB  - OBJECTIVES: The purpose of this study was to investigate the 2-year outcome of
      percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) 
      in patients with multivessel coronary artery disease (CAD). BACKGROUND: In
      patients with multivessel CAD undergoing PCI, coronary angiography is the
      standard method for guiding stent placement. The FAME (Fractional Flow Reserve
      Versus Angiography for Multivessel Evaluation) study showed that routine FFR in
      addition to angiography improves outcomes of PCI at 1 year. It is unknown if
      these favorable results are maintained at 2 years of follow-up. METHODS: At 20
      U.S. and European medical centers, 1,005 patients with multivessel CAD were
      randomly assigned to PCI with drug-eluting stents guided by angiography alone or 
      guided by FFR measurements. Before randomization, lesions requiring PCI were
      identified based on their angiographic appearance. Patients randomized to
      angiography-guided PCI underwent stenting of all indicated lesions, whereas those
      randomized to FFR-guided PCI underwent stenting of indicated lesions only if the 
      FFR was <or=0.80. RESULTS: The number of indicated lesions was 2.7+/-0.9 in the
      angiography-guided group and 2.8+/-1.0 in the FFR-guided group (p=0.34). The
      number of stents used was 2.7+/-1.2 and 1.9+/-1.3, respectively (p<0.001). The
      2-year rates of mortality or myocardial infarction were 12.9% in the
      angiography-guided group and 8.4% in the FFR-guided group (p=0.02). Rates of PCI 
      or coronary artery bypass surgery were 12.7% and 10.6%, respectively (p=0.30).
      Combined rates of death, nonfatal myocardial infarction, and revascularization
      were 22.4% and 17.9%, respectively (p=0.08). For lesions deferred on the basis of
      FFR>0.80, the rate of myocardial infarction was 0.2% and the rate of
      revascularization was 3.2 % after 2 years. CONCLUSIONS: Routine measurement of
      FFR in patients with multivessel CAD undergoing PCI with drug-eluting stents
      significantly reduces mortality and myocardial infarction at 2 years when
      compared with standard angiography-guided PCI. (Fractional Flow Reserve Versus
      Angiography for Multivessel Evaluation [FAME]; NCT00267774).
CI  - Copyright (c) 2010 American College of Cardiology Foundation. Published by
      Elsevier Inc. All rights reserved.
FAU - Pijls, Nico H J
AU  - Pijls NH
AD  - Catharina Hospital, Department of Cardiology, Eindhoven, the Netherlands.
      [email protected]
FAU - Fearon, William F
AU  - Fearon WF
FAU - Tonino, Pim A L
AU  - Tonino PA
FAU - Siebert, Uwe
AU  - Siebert U
FAU - Ikeno, Fumiaki
AU  - Ikeno F
FAU - Bornschein, Bernhard
AU  - Bornschein B
FAU - van't Veer, Marcel
AU  - van't Veer M
FAU - Klauss, Volker
AU  - Klauss V
FAU - Manoharan, Ganesh
AU  - Manoharan G
FAU - Engstrom, Thomas
AU  - Engstrom T
FAU - Oldroyd, Keith G
AU  - Oldroyd KG
FAU - Ver Lee, Peter N
AU  - Ver Lee PN
FAU - MacCarthy, Philip A
AU  - MacCarthy PA
FAU - De Bruyne, Bernard
AU  - De Bruyne B
CN  - FAME Study Investigators
LA  - eng
SI  - ClinicalTrials.gov/NCT00267774
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20100528
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - AIM
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*methods
MH  - *Coronary Angiography
MH  - Coronary Disease/surgery/*therapy
MH  - *Drug-Eluting Stents
MH  - Female
MH  - Follow-Up Studies
MH  - Fractional Flow Reserve, Myocardial/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality
MH  - Treatment Outcome
EDAT- 2010/06/12 06:00
MHDA- 2010/07/31 06:00
CRDT- 2010/06/12 06:00
PHST- 2009/12/08 [received]
PHST- 2010/04/06 [revised]
PHST- 2010/04/14 [accepted]
PHST- 2010/05/28 [aheadofprint]
AID - S0735-1097(10)01602-5 [pii]
AID - 10.1016/j.jacc.2010.04.012 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2010 Jul 13;56(3):177-84. doi: 10.1016/j.jacc.2010.04.012.
      Epub 2010 May 28.

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