In the FAME study, patients with multivessel coronary artery disease were randomly assigned to undergo percutaneous coronary intervention (PCI) guided by either angiography (in which case, all identified stenoses were revascularized) or fractional flow reserve (FFR; in which case, only stenoses with an FFR ≤0.80 were stented). The investigators now report the 5-year outcomes of the trial. Major adverse cardiac events (the primary end point) occurred in 31% of patients who underwent angiography-guided PCI and in 28% of patients who received FFR-guided PCI (P = 0.31). Moreover, fewer stents were placed in the angiography group (mean 1.9) than in the FFR group (mean 2.7; P <0.0001). The long-term safety and lower resource use mean that “FFR guidance of multivessel PCI should be the standard of care in most patients”, conclude the investigators.