TCT 2022 | FAME-3 Trial: post PCI FFR And IVUS in Patients with Three-Vessel Disease

We are well aware of the benefits of Fractional Flow Reserve (FFR) to assess coronary artery stenosis. FFR after PCI (post-PCI FFR) has been shown to have prognostic value; however, few studies have included patients with complex three-vessel disease. The impact of intravascular ultrasound (IVUS) or optical computer tomography (OCT) in this field has been even more overlooked.  

TCT 2022

The aim of this multicenter randomized study was to assess the prognostic value of post PCI FFR and intravascular imaging in patients undergoing PCI for three vessel disease in the FAME 3. 

Primary end point was target vessel failure (TVF), a combination of cardiovascular death, treated vessel MI (TVMI) and target vessel revascularization (TVR) at 1 year. 

Of 1500 patients included in the FAME 3 trial, 757 were randomized to FFR guided PCI. Of these, 61% were measured with FFR after PCI, and 15% had three-vessel disease. The artery most frequently assessed was the anterior descending, followed by the right coronary. Mean FFR value was 0.89. 9.1% had post PCI FFR 0.8 or lower. Post PCI FFR in the anterior descending artery was 0.87, while mean post PCI FFR in any other artery was 0.92.

Post PCI FFR value was a significant predictor of TVF at 1 year (HR=0.67 [95% CI: 0.48-0.93]. There was a significant and progressive reduction of TVF according to post PCI FFR values. 

Read also: TCT 2022 | BYPASS CTCA.

As regard IVUS imaging, there were no differences in cardiovascular death rate, AMI or the need for repeat revascularization vs. patients with no IVUS imaging. 

Conclusion

Post PCI FFR was an independent predictor of TVF in patients with three-vessel disease. The use of IVUS had no effect on the assessed outcomes. 

Dr. Andrés Rodríguez.
Member of the Editorial Board of SOLACI.org.

Original Title: Prognostic Value of Measuring Fractional Flow Reserve after Percutaneous Coronary Intervention in Patients with Complex Coronary Artery Disease: Insights from the FAME 3 Trial.

Reference: Zsolt Piroth, MD, PhD et al.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

More articles by this author

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

CRABBIS Trial: Comparison of Different Provisional Stenting Sequences

Provisional stenting (PS) is the gold standard for percutaneous coronary intervention (PCI) in most patients with coronary bifurcation lesions (CBL). Moreover, recent studies such...

Andromeda Trial: Meta-Analysis of Drug Coated Balloon vs. DES in Small Vessel DeNovo Lesions

The use of coronary stents vs plain old balloon angioplasty (POBA), has allowed to reduce recoil and limiting flow dissection which were major limitation...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

ACC-2025 Congress Second Day Key Studies

BHF PROTECT-TAVI (Kharbanda RK, Kennedy J, Dodd M, et al.)The largest randomized  trial carried out across 33 UK centers between 2020 and 2024, assessing...

ACC 2025 | FAME 3: FFR Guided PCI vs CABG 5 Year Outcomes.

Earlier studies comparing percutaneous coronary intervention (PCI) vs coronary artery bypass graft (CABG) have shown fewer events at long term for the surgical strategy.  However,...

ACC 2025 | API-CAT: Reduced vs. Full Dose Extended Anticoagulation in Patients with Cancer Related VTE

The risk of cancer related recurrent venous thromboembolism (VTE) will drop over time, while bleeding risk will persist. At present, it is recommended we...