Category Ranking
98%
Total Visits
921
Avg Visit Duration
2 minutes
Citations
20
Article Abstract
Importance: Outcomes in patients with diabetes after fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) using current-generation drug-eluting stents (DES) compared with coronary artery bypass grafting (CABG) are unknown.
Objectives: To investigate the relative treatment effect of PCI vs CABG according to diabetes status with respect to major adverse cardiac and cerebrovascular events (MACCE) at 3 years and to evaluate the impact of the SYNTAX score.
Design, Setting, And Participants: This is a prespecified subgroup analysis of the FAME (Fractional Flow Reserve vs Angiography for Multivessel Evaluation) 3 trial, an investigator-initiated, randomized clinical trial conducted at 48 centers worldwide. The FAME 3 trial enrolled patients with 3-vessel coronary artery disease not involving the left main undergoing coronary revascularization between August 2014 and December 2019. Data analysis was conducted in August 2023. Clinical follow-up was performed at hospital discharge and at 1 month, 6 months, 1 year, 2 years, and 3 years after randomization.
Intervention: Either FFR-guided PCI with current-generation DES or CABG.
Main Outcomes And Measures: The primary end point was MACCE, defined as the composite of all-cause death, myocardial infarction, stroke, or repeat revascularization at 3 years.
Results: Of 1500 total patients enrolled, mean (SD) patient age was 65.1 (8.4) years, and 265 patients (17.7%) were female. The FAME 3 trial included 428 patients with diabetes (28.5%). Patients with diabetes, especially those receiving insulin, had a higher risk of MACCE at 3 years compared with those without diabetes. Regarding relative treatment effect, the risk of MACCE was higher after FFR-guided PCI compared with CABG in both patients with diabetes (hazard ratio [HR], 1.44; 95% CI, 0.91-2.28; P = .12) and those without diabetes (HR, 1.50; 95% CI, 1.08-2.07; P = .02), with no significant interaction (P for interaction = .94). In patients with a low SYNTAX score (<23), there was no significant difference in MACCE between PCI and CABG, while in patients with an intermediate to high SYNTAX score (≥23), PCI had a higher risk of MACCE than CABG, regardless of diabetes status.
Conclusions And Relevance: In this subgroup analysis of the FAME 3 randomized clinical trial, the relative benefit of CABG compared with FFR-guided PCI was similar among patients with and without diabetes.
Trial Registration: ClinicalTrials.gov Identifier: NCT02100722.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11904802 | PMC |
| http://dx.doi.org/10.1001/jamacardio.2025.0095 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Tirzepatide for the Maintenance of Body Weight Reduction: Rationale, Design, and Baseline Characteristics of SURMOUNT-MAINTAIN.
Obesity (Silver Spring)
September 2025
Eli Lilly and Company, Indianapolis, Indiana, USA.
Objective: SURMOUNT-MAINTAIN aims to evaluate the efficacy and safety of reducing the tirzepatide dose and/or continuing the maximum tolerated dose (MTD) versus placebo in maintaining body weight (BW) reduction achieved with tirzepatide MTD.
Methods: This Phase 3b, multicenter, randomized, parallel-arm, double-blinded, placebo-controlled, 52-week clinical trial is in progress comparing treatment with once weekly tirzepatide (5 mg and/or MTD of 15 mg or 10 mg) versus placebo in achieving BW reduction maintenance from the initial 60-week open-label weight-loss period on tirzepatide MTD, in adults with obesity (BMI ≥ 30 kg/m or ≥ 27 kg/m with ≥ 1 obesity-related comorbidity, excluding type 2 diabetes). The primary endpoint is percent maintenance of BW reduction achieved during the weight-loss period at Week 112 among those who reached a BW plateau (i.
Sodium-glucose cotransporter 2 inhibitors may increase iron availability with beneficial effects on erythropoiesis and cardiovascular mortality in patients with type 2 diabetes mellitus.
Eur J Intern Med
September 2025
Department of Haematology, Beaumont Hospital, Dublin 9, Ireland. Electronic address:
Approach to contrast agent-induced acute kidney injury after elective percutaneous coronary intervention in patients with diabetes.
J Cardiol
September 2025
Department of Cardiology, Tokat Gaziosmanpaşa University, Tokat, Turkey.
Impact of transitioning from conventional blood glucose monitoring to continuous glucose monitoring on glycemic control and self-management in adults with type 2 diabetes on oral glucose-lowering medications.
Diabetes Res Clin Pract
September 2025
Health Education Department, and Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Background: Despite advances, glycemic control in people with type 2 diabetes (PwT2D) treated with oral antidiabetic medications (ADMs) often remains suboptimal. Continuous glucose monitoring (CGM) has shown promise in diabetes management, offering real-time insights into glucose trends. This study evaluates the impact of transitioning from conventional self-monitoring of blood glucose (SMBG) to CGM on glycemic outcomes and self-management in PwT2D receiving oral ADMs.
View Article and Find Full Text PDFIncidence of death and amputation in patients with a first diabetic foot ulcer: results from the CODIA cohort.
Diabetes Metab
September 2025
Paris Diabetology Federation, Paris, France; Institut Necker Enfants Malades, INSERM U1151, CNRS UMR 8253, IMMEDIAB Laboratory, Université Paris Cité, Paris, France; Department of Diabetology and Endocrinology, Bichat Hospital, AP-HP, Paris, France.
Aim: - To investigate the incidences of death and lower limb amputation (LLA) among patients hospitalized with a first diabetic foot ulcer and to identify the associated risk factors.
Methods: - We leveraged medical records from 08/2017 to 10/2023 in the clinical data warehouse of the Greater Paris Hospitals. The primary outcome was the cumulative incidence of death estimated at 12 months.