Which Is More Enduring — FAME or COURAGE?

Since the advent of percutaneous coronary intervention (PCI) in 1977,1 visual assessment of the severity of coronary stenosis has been used to guide revascularization in patients with coronary artery disease. Almost 20 years ago, however, a technique was developed to directly measure the functional stenosis severity with the use of an intracoronary pressure wire to quantify the transstenotic pressure gradient before and after PCI.2,3 Subsequently, pressure-derived fractional flow reserve (FFR) was evaluated in the Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) trial, in which patients were randomly assigned to conventional, angiographically directed PCI or FFR-guided PCI (with . . .