Key result
FFR-guided PCI decreased lifetime healthcare costs by $2,451 and increased QALYs by 0.178 compared with IVUS-guided PCI for intermediate coronary lesions in Korea.
Why the study?
Following the FLAVOUR trial demonstrating non-inferiority of FFR-guided PCI compared with IVUS-guided PCI, the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea remained to be investigated.
Does fractional flow reserve (FFR)-guided PCI improve cost-effectiveness compared to intravascular ultrasound (IVUS)-guided PCI in patients with intermediate coronary stenosis?
Population
Patients undergoing PCI to treat intermediate stenosis (40% to 70% stenosis on coronary angiography)
Comparison
FFR-guided PCI vs IVUS-guided PCI
Design
2-part cost-effectiveness model (short-term decision tree and long-term Markov model)
Follow-up
Lifetime
Authors
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May support FFR over IVUS for cost-effectiveness in Korea; leaves open need for randomized confirmation before practice change.
RCT
Does fractional flow reserve (FFR)-guided PCI improve cost-effectiveness compared to intravascular ultrasound (IVUS)-guided PCI in patients with intermediate coronary stenosis?
Effect estimate: Cost difference -$2,451, QALY difference +0.178
FFR-guided PCI is a dominant, cost-effective strategy compared to IVUS-guided PCI for intermediate coronary lesions in the Korean healthcare system.
Hwang et al. (2024) conducted an RCT in Intermediate coronary stenosis. Fractional flow reserve (FFR)-guided PCI vs. Intravascular ultrasound (IVUS)-guided PCI was evaluated on Lifetime healthcare costs and quality-adjusted life-years (QALYs) (Cost difference -$2,451, QALY difference +0.178). FFR-guided PCI decreased lifetime healthcare costs by $2,451 and increased QALYs by 0.178 compared with IVUS-guided PCI for intermediate coronary lesions in Korea.
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