FFR-Guided PCI Beats Optimal Medical Therapy for Severe Stable CAD

Two-year results of the FAME 2 trial show a significant reduction in urgent revascularizations with PCI.

The COURAGE trial demonstrated that optimal medical therapy (OMT) should be the default strategy for most patients with stable coronary artery disease (CAD; NEJM JW Cardiol Mar 29 2007); subsequently, the FAME trial showed that the use of fractional flow reserve (FFR) measurement during coronary angiography is superior to angiography alone for guiding percutaneous coronary intervention (PCI) in these patients (NEJM JW Cardiol Jan 14 2009). The manufacturer-funded, open-label, randomized FAME 2 trial, comparing FFR-guided PCI and OMT with OMT alone in 880 patients with stable CAD and severe stenoses (defined as FFR ≤0.80), was stopped early because of a highly significant benefit with PCI in regard to the primary endpoint (NEJM JW Cardiol Au…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)