Why is this study important?

• In multi-vessel coronary artery disease, compared to CABG, FFR-guided PCI has similar quality of life, angina relief and return to work. 
• FFR-guided PCI results in a faster improvement in quality of life than CABG during the first year after revascularization, and improved working status in patients <65 years old. 

What question was this study supposed to answer?  

• Management of patients with multi-vessel coronary disease is a clinical challenge we face every day, FAME-3 compares the two main treatment options, FFR-guided PCI and CABG. The primary end point was MACCE and repeat revascularization, PCI did not meet non-inferiority at one year as presented at TCT in November 2021. Both study arms had low event rates, and the differences between PCI and CABG narrowed compared to previous studies, which prompted the quality-of-life sub study to further aid in clinical decision making. 

What did the study show?  

• This quality-of-life sub study showed that FFR-guided PCI have similar quality of life and angina relief compared to CABG at one year, in the younger than 65 y.o group, CABG was associated with less return to work compared to PCI at 1, 6 and 12 months. 

All editors: Luai Tabaza, MD