Research In Brief
This article was originally published in The Gray Sheet
Executive Summary
Test improves DES outcomes: Routine measurement of fractional flow reserve (FFR) - the ratio of maximal blood flow in a stenotic artery to normal maximal flow - with St. Jude's PressureWire Certus guidewire-mounted sensor improves outcomes of drug-eluting stent implants in patients with multivessel coronary artery disease, according to results of the FAME trial published in the Jan. 15 New England Journal of Medicine. The 20-center trial randomized 1,005 patients with multivessel disease to undergo implantation of drug-eluting stents guided by angiography and FFR or drug-eluting stent implantation guided by angiography alone. The overall composite adverse event rates were 18.3% in the angiography-alone group and 13.2% in the FFR group. Adverse events included death, non-fatal myocardial infarction and repeat revascularization. The trial also showed that including FFR in the procedure saved money and only added one minute to the average procedure time (71 minutes versus 70 minutes). The average procedure cost was $6,007 in the angiography-alone group compared to $5,332 for the FFR group, partly because FFR measurement led to the implant of fewer stents. The FFR group received an average of 1.9 stents per patient compared to 2.7 for the angiography-alone group, even though patients in the FFR group had an average of 2.8 coronary lesions compared to 2.7 for the angiography-alone group. The study was sponsored by Medtronic, Friends of the Heart Foundation and St. Jude Medical/Radi Medical Systems