Has the FAME 3 trial showing similar 5-year mortality between FFR-guided PCI and CABG changed your default revascularization recommendation in a patient with three-vessel coronary artery disease who is eligible for both procedures?
FAME 3 continues to show a lasting effect of CABG in terms of less MI and revascularization.
The decision about revascularization in a patient with multi-vessel disease rests on three pillars.
- Complexity of the patient's coronary artery disease, their presentation, and patient preference.
- Patient fac...
Yes, it has, but only for a subset of patients like those who decline CABG, those with frailty, those with prior CVA, or those with a hostile mediastinum, primarily because of higher repeat revascularization and MI rates in the PCI group. CABG, otherwise, remains the gold standard for significant 3...
The 5-year results of FAME 3 have reinforced, but not fundamentally changed, my approach. The finding of similar all-cause mortality between FFR-guided PCI and CABG is reassuring, but mortality is only one outcome. CABG still provides greater freedom from repeat revascularization and myocardial infa...