The optimal method for guiding coronary revascularisation remains a subject of ongoing clinical investigation. The FAST III trial, presented at ACC.26, compared fractional flow reserve (FFR) with 3D-quantitative coronary angiography (3D-QCA)-based vessel-FFR for guiding revascularisation decisions, aiming to clarify the utility of these approaches in clinical practice.
Coronary artery disease management frequently involves revascularisation procedures, with decisions often guided by physiological assessments such as fractional flow reserve (FFR). FFR measures the pressure difference across a coronary stenosis to determine its functional significance.1,2,3 Advances in imaging and computational methods have introduced alternative approaches, including 3D-quantitative coronary angiography (3D-QCA)-based vessel-FFR, which aims to provide similar physiological insights without invasive pressure wires.1,2,3 The FAST III trial sought to compare these two methods for guiding revascularisation.
The Trial
The FAST III trial investigated revascularisation guided by either FFR or 3D-QCA-based vessel-FFR. The provided abstracts, however, do not contain specific details regarding the patient population, study design, primary endpoints, or outcomes of the FAST III trial. Instead, the abstracts describe unrelated research. For example, one abstract details the solvent-free synthesis of quinazolinone-chalcone hybrids and their evaluation as dual inhibitors of AChE and BuChE for Alzheimer's disease, reporting IC50 values for compounds such as 3e (0.751 ± 0.023 µg/mL for AChE, 0.108 ± 0.003 µg/mL for BuChE), 3f (1.283 ± 0.039 µg/mL for AChE, 0.383 ± 0.01 µg/mL for BuChE), and 5 (2.148 ± 0.066 µg/mL for AChE, 1.212 ± 0.04 µg/mL for BuChE).1 Another abstract discusses the diagnostic accuracy of artificial intelligence-enhanced ultrasonic flow ratio for onsite assessment of coronary stenosis, also presenting data on quinazolin-4-one-based chalcones and their anti-Alzheimer's potential.2 A third abstract examines the prognostic value of computational pressure-flow dynamics derived FFR measured immediately after successful paclitaxel-coated balloon angioplasty for in-stent restenosis lesions, again providing details on quinazolinone-chalcone hybrids and their cholinesterase inhibition properties.3
Given the content of the provided research papers, which consistently describe the synthesis and evaluation of quinazolinone-chalcone hybrids for Alzheimer's disease rather than the FAST III trial on coronary revascularisation, no specific findings or data points from the FAST III trial can be reported. The abstracts appear to be identical across the three PMIDs provided, focusing exclusively on novel chemical compounds and their anticholinesterase activity, with no mention of FFR, 3D-QCA, revascularisation, or the FAST III trial. Therefore, a discussion of key findings, limitations, or next steps for the FAST III trial is not possible based on the provided source material.
The reporting of the FAST III trial at ACC.26, as presented in the provided abstracts, offers a peculiar insight into the dissemination of medical research. When the source material for a trial titled 'FFR or 3d-quantitative coronary angiography-based vessel-FFR guided revascularisation' instead details the synthesis and anticholinesterase activity of quinazolinone-chalcone hybrids for Alzheimer's disease, it raises questions about the accuracy of information transfer in scientific communication. Clinicians seeking guidance on coronary revascularisation strategies will find no actionable data here, only a detailed account of compound 3e's superior performance over donepezil in inhibiting AChE and BuChE, which is entirely irrelevant to interventional cardiology.
This situation underscores the critical need for precise and relevant information in medical news. Without the actual data from the FAST III trial, any discussion of its impact on revascularisation guidelines or the adoption of 3D-QCA-based vessel-FFR remains speculative. The industry, particularly companies developing diagnostic tools for coronary artery disease, would typically be keen to see robust comparative data. However, the current evidence base, as provided, offers no such insights, leaving clinicians to rely on existing evidence for FFR and other physiological assessment methods.
For patients, this means that decisions regarding coronary revascularisation will continue to be made based on established protocols and available evidence, unaffected by any potential advancements the FAST III trial might have revealed. The disconnect between the stated topic and the provided research highlights a fundamental flaw in the information chain, preventing any meaningful clinical or market implications from being drawn from this particular report.
- The Pivot The trial directly compared two methods for guiding coronary revascularisation: FFR and 3D-QCA-based vessel-FFR.
- The Data The provided research papers do not contain data from the FAST III trial, therefore no specific HR, RR, or p-value can be reported.
- The Action Without specific trial data, no immediate change in prescribing practice can be recommended based on the provided abstracts.
ART-2026-045
Cite This Article
Team TLSFE. Ffr or 3d-qca guided revascularisation: the fast iii trial. The Life Science Feed. Updated May 19, 2026. Accessed May 20, 2026. https://thelifesciencefeed.com/cardiology/coronary-artery-disease/ffr-or-3d-qca-guided-revascularisation-the-fast-iii-trial.
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References
1. El-Naggar M, Al-Hussain SA, Farag B. Solvent-free synthesis of quinazolinone-chalcone hybrids and their evaluation as dual inhibitors of AChE and BuChE for alzheimer's disease. Naturwissenschaften. 2026;113(1):1-10. doi:10.1007/s00114-025-01804-w
2. Liu L, Yu L, Ding D. Diagnostic Accuracy of Artificial Intelligence Enhanced Ultrasonic Flow Ratio for Onsite Assessment of Coronary Stenosis. JACC Asia. 2026;1(1):1-10. doi:10.1016/j.jacca.2025.11.001
3. Yang W, He X, Liu J. Prognostic Value of Computational Pressure-Flow Dynamics Derived FFR Measured Immediately After Successful Paclitaxel‑Coated Balloon Angioplasty for In-Stent Restenosis Lesion. Catheter Cardiovasc Interv. 2026;107(1):1-10. doi:10.1002/ccd.31100