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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?

Hlatky et al., PMID 41194756
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What is your default revascularization strategy in an eligible patient with three-vessel coronary artery disease?

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3 Answers
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Cardiology · ETSU Health Care
Answered on

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.

  1. Complexity of the patient's coronary artery disease, their presentation, and patient preference.
  2. Patient fac...

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Cardiology · University Of California San Francisco Medical Center At Parnassus
Answered on

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...

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Mednet Member
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Cardiology · Interventional cardiologist
Answered on

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-...

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