FFR / Fame

FFR vs. Angiography for Multivessel Evaluation (FAME)

Pijls NH, Fearon WF, Tonino PA, Siebert U, Ikeno F, Bornschein B, van't Veer M, Klauss V, Manoharan G, Engstrøm T, Oldroyd KG, Ver Lee PN, MacCarthy PA, De Bruyne B; FAME Study Investigators.

N Engl J Med 2009;360:213-24.

OBJECTIVES:

Investigate whether routine measurement of fractional flow reserve (FFR; the ratio of maximal blood flow in a stenotic artery to normal maximal flow), in addition to angiography, improves outcomes of patients with multivessel disease (MVD).

METHODS:

• 1,005 patients
• 20 European and U.S. centers
• Randomized
• DES only
• Multivessel coronary artery disease only
• Angiography guidance alone versus angiography plus FFR
• PCI for every lesion with FFR ≤ 0.80
• No PCI for FFR group patients with FFR > 0.80
• 1 year follow-up

SUMMARY:

• The mean (± SD) number of indicated lesions per patient was 2.7 ± 0.9 in the angiography group and 2.8 ± 1.0 in the FFR group (P = 0.34).
• The number of stents used per patient was 2.7 ± 1.2 in the angiography group and 1.9 ± 1.3 in the FFR group (P < 0.001).
• The 1-year event rate was 18.3 % (91 patients) in the angiography group and 13.2 % (67 patients) in the FFR group (P = 0.02).
• Seventy-eight percent of the patients in the angiography group were free from angina at 1 year, as compared with 81 % of patients in the FFR group (P = 0.20).

CONCLUSIONS:

Routine measurement of FFR in patients with multivessel disease (MVD) who are undergoing PCI with drug-eluting stents (DES) significantly improves outcomes at 1 year by reducing MACE (composite rate of death, nonfatal myocardial infarction, and repeat revascularization).

FAME STUDY SUMMARY ( DOWNLOAD PDF )

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