Evidence map›Paper›PMID 25179764›Full record

Trial reportEuropean heart journal2015

Fractional flow reserve vs. angiography in guiding management to optimize outcomes in non-ST-segment elevation myocardial infarction: the British Heart Foundation FAMOUS-NSTEMI randomized trial.

Jamie Layland, Keith G Oldroyd, Nick Curzen, Arvind Sood, Kanarath Balachandran, Raj Das, Shahid Junejo, Nadeem Ahmed, Matthew M Y Lee, Aadil Shaukat and 7 more

3 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 115 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
115citing papers in PubMed, 19 pooled it
28.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01764334 phase4unknown statusnot on this map

A Developmental Clinical Study of Management Guided by Coronary Angiography Combined With Fractional Flow Reserve (FFR) Measurement Versus Management Guided by Coronary Angiography Alone(Standard Care) in Patients With Non-ST Elevation MI.

TypeinterventionalSponsorNHS National Waiting Times Centre BoardRan2011 to 2020Enrolled350ConditionsNonST Elevation Myocardial Infarction, Myocardial InfarctionArmsFractional flow reserve
NCT02590926 completednot on this map

Safety of Negative FrActional Flow Reserve in Patients With ChallEnging Lesions

Typeobservational_patient_registrySponsorA.O.U. Città della Salute e della ScienzaRan2014 to 2017Enrolled285ConditionsFractional Flow Reserve, MyocardialArmsFractional Flow Reserve, Myocardial
NCT03205514 completednot on this mapstarted 2017, after this paper: background citation

Multimodality Investigation of Intermediate Culprit Lesion With Negative Fractional Flow Reserve in Patients With no ST-segment Elevation Acute Coronary Syndrome.

Typeobservational_patient_registrySponsorUniversity Hospital of FerraraRan2017 to 2021Enrolled35ConditionsMyocardial IschemiaArmsNSTE-ACS with intermediate stenosis and negative FFR
3 · Its place in the literature

Who cites it

115 citing papers in PubMed, 19 syntheses or guidelines pooled it, 313 citations in OpenAlex.

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  20. Quantitative flow ratio or angiography for the assessment of non-culprit lesions in acute coronary syndromes, a randomized trial.Clinical research in cardiology : official journal of the German Cardiac Society · 2025
    Trial

55 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 8 institutions in 1 country.

Jamie LaylandWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK.
Keith G OldroydWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
Nick CurzenUniversity Hospital Southampton Foundation Trust, Southampton, UK.
Arvind SoodHairmyres Hospital, East Kilbride, UK.
Kanarath BalachandranRoyal Blackburn Hospital, Blackburn, UK.
Raj DasFreeman Hospital, Newcastle, UK.
Shahid JunejoCity Hospitals Sunderland Foundation Trust, Sunderland, UK.
Nadeem AhmedWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
Matthew M Y LeeWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
Aadil ShaukatWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
Anna O'DonnellWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK.
Julian NamHealth Economics and Health Technology Assessment Unit, University of Glasgow, Glasgow, UK.
Andrew BriggsHealth Economics and Health Technology Assessment Unit, University of Glasgow, Glasgow, UK.
Robert HendersonTrent Cardiac Centre, Nottingham University Hospitals, Nottingham, UK.
Alex McConnachieRobertson Centre for Biostatistics, University of Glasgow, UK.
Colin BerryWest of Scotland Heart and Lung Centre, Golden Jubilee National Hospital, Clydebank, UK BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK colin.berry@glasgow.ac.uk.
FAMOUS–NSTEMI investigators
Golden Jubilee National Hospital · GBNottingham University Hospitals NHS Trust · GBUniversity of Glasgow · GBFreeman Hospital · GBHairmyres Hospital · GBSouth Tyneside and Sunderland NHS Foundation Trust · GBUniversity Hospital Southampton NHS Foundation Trust · GBRoyal Blackburn Teaching Hospital · GB

Funding

British Heart Foundation PG/11/55/28999
6 · The paper itself

Abstract

aimWe assessed the management and outcomes of non-ST segment elevation myocardial infarction (NSTEMI) patients randomly assigned to fractional flow reserve (FFR)-guided management or angiography-guided standard care. METHODS AND

resultsWe conducted a prospective, multicentre, parallel group, 1 : 1 randomized, controlled trial in 350 NSTEMI patients with ≥1 coronary stenosis ≥30% of the lumen diameter assessed visually (threshold for FFR measurement) (NCT01764334). Enrolment took place in six UK hospitals from October 2011 to May 2013. Fractional flow reserve was disclosed to the operator in the FFR-guided group (n = 176). Fractional flow reserve was measured but not disclosed in the angiography-guided group (n = 174). Fractional flow reserve ≤0.80 was an indication for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). The median (IQR) time from the index episode of myocardial ischaemia to angiography was 3 (2, 5) days. For the primary outcome, the proportion of patients treated initially by medical therapy was higher in the FFR-guided group than in the angiography-guided group [40 (22.7%) vs. 23 (13.2%), difference 95% (95% CI: 1.4%, 17.7%), P = 0.022]. Fractional flow reserve disclosure resulted in a change in treatment between medical therapy, PCI or CABG in 38 (21.6%) patients. At 12 months, revascularization remained lower in the FFR-guided group [79.0 vs. 86.8%, difference 7.8% (-0.2%, 15.8%), P = 0.054]. There were no statistically significant differences in health outcomes and quality of life between the groups.

conclusionIn NSTEMI patients, angiography-guided management was associated with higher rates of coronary revascularization compared with FFR-guided management. A larger trial is necessary to assess health outcomes and cost-effectiveness.

Indexed as

Coronary AngiographyCoronary StenosisCosts and Cost AnalysisElectrocardiographyFemaleFractional Flow Reserve, MyocardialHealth ResourcesHospitalizationHumansMaleMiddle AgedMyocardial InfarctionMyocardial RevascularizationProspective StudiesQuality of LifeRadiography, InterventionalAcute coronary syndromeCoronary revascularizationFractional flow reserveMedical therapyNon-ST elevation myocardial infarction

Identifiers

PMID25179764
PMCPMC4291317
OpenAlexW2150801605

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.