Key result
Fractional flow reserve-based management of intermediate coronary lesions in 59 patients avoided 26 stents and yielded a net cost benefit of USD 15,600 compared to angiography alone.
Why the study?
Does FFR-based management improve clinical decision making and cost-effectiveness compared to angiography alone in Indian patients with intermediate severity CAD?
Observational (n=59)
No
Does FFR-based management improve clinical decision making and cost-effectiveness compared to angiography alone in Indian patients with intermediate severity CAD?
FFR-based management of intermediate coronary lesions in Indian patients reduces unnecessary stenting and provides significant cost savings without compromising medium-term safety.
FFR may reduce unnecessary stents and costs in intermediate lesions; leaves open confirmation in larger randomized studies.
OBJECTIVES: To study the clinical usefulness, cost benefit, and medium term outcome of fractional flow reserve (FFR) based management of coronary artery disease of intermediate severity. BACKGROUND: In spite of the advantages of FFR there is paucity of data in Indian population who have frequent diffuse, small and multivessel disease where it would probably be more beneficial in terms of cost and outcome. METHODS: The treating cardiologist's management decision with both FFR and angiographic data was compared with that of a reviewing cardiologist decision based on a retrospective analysis of angiogram alone. RESULTS: Eighty-one vessels with intermediate lesions in 59 patients required 26 stents lesser when FFR data was added to the angiogram. The concordance of management decision was about 58% which means that >40% of intermediate lesions would be misclassified as significant based on angiography alone. There were no major events at a mean follow up of 11 ± 5 months. The net cost benefit in favor of FFR based management was INR 8,57,600 (USD 15,600) in our centre. CONCLUSION: Indians with more severe form of CAD benefit from a FFR based management plan for intermediate lesions, both clinically and economically.
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Sengottuvelu et al. (2014) conducted an observational in Coronary artery disease of intermediate severity (n=59). Fractional flow reserve (FFR) based management vs. Angiography alone was evaluated on Concordance of management decision between FFR + angiography and angiography alone. Fractional flow reserve-based management of intermediate coronary lesions in 59 patients avoided 26 stents and yielded a net cost benefit of USD 15,600 compared to angiography alone.
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