Two years ago at the ESC meeting in Munich, initial findings from the FAME 2 randomized trial, which was stopped early for apparent benefit, were presented and simultaneously published in the New England Journal of Medicine<\/a>. In a blog for CardioExchange<\/a>, Rick Lange and David Hillis posed 7 concerns about the trial and asked, “Should we be performing PCI in all stable CAD patients who have abnormal FFR?”<\/p>\n Now, the FAME 2 investigators have presented and published their 2-year findings<\/a>:<\/p>\n
| \n Endpoints<\/strong><\/p>\n<\/td>\n PCI + Medical Therapy<\/strong><\/p>\n<\/td>\n Medical Therapy Alone<\/strong><\/p>\n<\/td>\n P<\/em> value<\/strong><\/p>\n<\/td>\n<\/tr>\n 8.1%<\/p>\n<\/td>\n 19.5%<\/p>\n<\/td>\n <0.001<\/p>\n<\/td>\n<\/tr>\n 1.3%<\/p>\n<\/td>\n 1.8%<\/p>\n<\/td>\n 0.58<\/p>\n<\/td>\n<\/tr>\n 5.8%<\/p>\n<\/td>\n 6.8%<\/p>\n<\/td>\n 0.56<\/p>\n<\/td>\n<\/tr>\n 4.0%<\/p>\n<\/td>\n 16.3%<\/p>\n<\/td>\n <0.001<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n <\/p>\n The numbers have changed, but the between-group differences are largely the same.<\/p>\n Asked to comment, Hillis responded:<\/p>\n It is interesting that FFR-driven PCI reduced only the need for urgent revascularization, not the other components of the combined primary end-point. One could argue that this is not terribly surprising, since these flow-limiting stenoses will probably be more likely than less severe ones to cause limiting symptoms that do not respond adequately to medical therapy, thereby requiring revascularization.<\/p><\/blockquote>\n |