2009InterventionCoronary artery disease1005 patients

FAME

Therapy group: Coronary physiology · Therapy: FFR-guided vs angiography-guided PCI in multivessel disease

In multivessel coronary disease, FFR-guided PCI reduced death, myocardial infarction and repeat revascularization at one year versus angiography guidance alone.

Published in N Engl J Med (2009)

Question: Does routine measurement of fractional flow reserve (FFR), in addition to angiography, improve outcomes of PCI with drug-eluting stents in patients with multivessel coronary artery disease?
Design: Randomized, open-label (no masking) trial of 1005 patients at 20 centers in the United States and Europe. Lesions requiring PCI were identified angiographically before randomization.
Population: Patients with multivessel coronary artery disease undergoing PCI with drug-eluting stent implantation.
Intervention: FFR-guided PCI in addition to angiography: indicated lesions were stented only if the FFR was 0.80 or less.
Control: Angiography-guided PCI alone, with stenting of all indicated lesions.
Primary outcome: Composite of death, nonfatal myocardial infarction, and repeat revascularization at 1 year.
Results: The 1-year event rate was 18.3% (91 patients) with angiography and 13.2% (67 patients) with FFR (P=0.02). The number of stents per patient was 2.7±1.2 with angiography and 1.9±1.3 with FFR (P<0.001).
Safety: Safety is reflected in the primary composite, which included death and nonfatal myocardial infarction; the abstract does not report other safety findings separately.
Conclusion: Routine FFR measurement in PCI with drug-eluting stents for multivessel disease significantly reduced the composite of death, nonfatal myocardial infarction, and repeat revascularization at 1 year.
Why it matters: It established that deciding on PCI by the functional significance of lesions, rather than angiographic appearance alone, improves outcomes while allowing fewer stents to be implanted, driving the adoption of invasive coronary physiology.

Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.

Generated on October 18, 2026

Sources

Original publication on PubMed (PMID 19144937) ↗Fractional flow reserve versus angiography for guiding percutaneous coronary intervention.
Journal article (DOI) ↗
ClinicalTrials.gov record (NCT00267774) ↗

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