FAME pubbed in NEJM: is FFR ready to step into the spotlight?

One of the most intriguing studies at last fall’s TCT was FAME, which tested the value of fractional flow reserve (FFR) versus conventional angiography for guiding PCI. Now the study has been published in the New England Journal of Medicine, accompanied by an editorial written by Stephen Ellis.

The use of FFR resulted in a significant reduction in MACE at one year in FAME. Ellis points out a number of important limitations of the study but holds out hope for the utility of FFR. He believes  FFR needs a validation study before it can be considered for routine clinical practice.

Ellis alludes to one potentially controversial aspect of FAME and FFR when he writes that “interventional cardiologists should recognize the limitations of coronary angiography and PCI.” Here’s the point: if FFR in fact can predict which lesions will benefit from PCI, it’s hard to avoid the conclusion that PCI for non-FFR indicated lesions may actually be harmful. I wonder if anyone will have the COURAGE to pursue this line of thought…

You can see the FAME slide set at ClinicalTrialResults.com, where it was originally posted following the initial TCT presentation.

You can also view a video interview with FAME investigator Nico Pijls by C. Michael Gibson on ClinicalTrialResults.com.


  1. […] according to  Nico HJ Pijls, who presented 18 month data from FAME at the ESC in Barcelona. The one year results of FAME, presented a year ago at TCT and published earlier this year in the NEJM, concluded that […]

  2. […] One year results of the trial were published last winter in the NEJM, and concluded  that “routine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point of death, nonfatal myocardial infarction, and repeat revascularization at 1 year.” MACE-free survival at one year was 18.4% in the routinely treated group versus 13.2% in the FFR group, an absolute difference of 5.1%. […]

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