{"id":9146,"date":"2025-11-03T12:07:35","date_gmt":"2025-11-03T09:07:35","guid":{"rendered":"https:\/\/jordan-cardiac.org\/?p=9146"},"modified":"2025-11-03T12:07:35","modified_gmt":"2025-11-03T09:07:35","slug":"pci-vs-cabg-equal-survival-lower-cost-fame-3-five-year-update","status":"publish","type":"post","link":"https:\/\/jordan-cardiac.org\/en\/pci-vs-cabg-equal-survival-lower-cost-fame-3-five-year-update\/","title":{"rendered":"PCI vs CABG: Equal Survival, Lower Cost \u2014 FAME 3\u00a0 (Five-Year Update)"},"content":{"rendered":"<div>PCI vs CABG: Equal Survival, Lower Cost \u2014 FAME 3<\/div>\n<div>(Five-Year Update)<\/div>\n<div><\/div>\n<div>Source: TCT 2025 | JACC,Oct 27 2025<\/div>\n<div><\/div>\n<div>Keynotes:<\/div>\n<div><span> 1. Design: 1,500 patients with three-vessel CAD randomized to FFR-guided PCI vs CABG.<\/span><\/div>\n<div><span> 2. Primary outcome (Death + MI + Stroke): No significant difference \u2014 16.0 % (PCI) vs 14.1 % (CABG); HR 1.16 (95 % CI 0.89\u20131.52); P = 0.27.<\/span><\/div>\n<div><span> 3. Mortality: Identical \u2014 7.2 % each.<\/span><\/div>\n<div><span> 4. MI &amp; Repeat revascularization: Higher with PCI (~8 % and 16 %) vs CABG (~5 % and 8 %).<\/span><\/div>\n<div><span> 5. Cost-effectiveness: PCI \u2248 30 % less expensive ($25.7 K vs $39.9 K); QALY slightly higher (4.05 vs 4.03).<\/span><\/div>\n<div><span> 6. Functional recovery: Employment at 5 years = 56 % (PCI) vs 47 % (CABG) \u2192 faster recovery and return to work.<\/span><\/div>\n<div><span> 7. Interpretation: Modern FFR-guided PCI provides comparable safety and superior economic value for appropriately selected three-vessel patients, while CABG retains advantage for complex anatomy or diabetes.<\/span><\/div>\n<div><span> 8. Extended evidence:<\/span><\/div>\n<div>\u2003\u2022 SYNTAX (10 Years): Comparable survival, but CABG fewer MIs and reinterventions in high-complexity disease.<\/div>\n<div>\u2003\u2022 BEST (\u2248 10 Years): No difference in overall mortality; PCI had higher MI and repeat procedures.<\/div>\n<div>\u2003\u2022 FREEDOM (10 Years, Diabetics): CABG clearly superior for major events.<\/div>\n<div>\u2003\u2022 (No randomized studies beyond 10 years using modern DES and FFR techniques exist to date.)<\/div>\n<div><span> 9. Take-home: For lower-complexity multivessel CAD, PCI is a safe, cost-effective alternative; CABG remains preferred for high SYNTAX scores and diabetic patients.<\/span><\/div>\n<div><\/div>\n<div>(Earlier long-term trials \u2014 including the 20-year follow-up from early PCI vs CABG studies such as the Dutch trials and MASS II \u2014 provide historical insight but reflect pre-DES technology, making them not directly comparable to today\u2019s FFR-guided or modern DES outcomes.)<\/div>\n<div><\/div>\n<div><a href=\"https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2025.10.017\">https:\/\/www.jacc.org\/doi\/10.1016\/j.jacc.2025.10.017<\/a><\/div>\n<div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>PCI vs CABG: Equal Survival, Lower Cost \u2014 FAME 3 (Five-Year Update) Source: TCT 2025 | JACC,Oct 27 2025 Keynotes: 1. Design: 1,500 patients with three-vessel CAD randomized to FFR-guided PCI vs CABG. 2. Primary outcome (Death + MI + Stroke): No significant difference \u2014 16.0 % (PCI) vs 14.1 % (CABG); HR 1.16 (95 [&hellip;]<\/p>\n","protected":false},"author":145,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9146","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9146","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/users\/145"}],"replies":[{"embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/comments?post=9146"}],"version-history":[{"count":1,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9146\/revisions"}],"predecessor-version":[{"id":9147,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/posts\/9146\/revisions\/9147"}],"wp:attachment":[{"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/media?parent=9146"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/categories?post=9146"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jordan-cardiac.org\/en\/wp-json\/wp\/v2\/tags?post=9146"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}