Using fractional flow reserve (FFR) measurements to guide percutaneous coronary intervention (PCI) procedures can lead to significant cost savings, according to new findings published in JAMA Network Open.[1]
The study’s authors examined data from more than 500 patients who presented with a history of acute myocardial infarction and multivessel disease. All participants underwent complete revascularization by non-infarct-related artery (IRA) PCI in South Korea from August 2016 to December 2020. The mean patient age was 63.3 years old, and 84.3% were men. Patients were randomized to either receive FFR-guided PCI or angiography-guided PCI.
“In the FFR-guided PCI group, FFR was measured in all non-IRA lesions with stenosis greater than 50% on visual estimation and only stenoses with an FFR of 0.80 or lower were treated with PCI,” explained first author David Hong, MD, a specialist with the Sungkyunkwan University School of Medicine in South Korea, and colleagues. “In the angiography group, any lesions with diameter stenosis greater than 50% on visual estimation were treated with PCI.”
Overall, Hong and colleagues determined that FFR-guided PCI was associated with a significantly lower risk of death, myocardial infarction or repeat revascularization than angiography-guided PCI. It was also linked to approximately $1,200 in savings per patient.
In addition, the incremental net monetary benefit of FFR-guided PCI was $3,378, which means it represents a cost-effective treatment option when directly compared to angiography-guided PCI.
On top of its primary analysis, the group used a Markov probability model to track the cost-effectiveness of FFR-guided PCI in Korea, the United States and Europe. This secondary analysis revealed that FFR delivers even more value to heart teams based out of the United States than it does in other parts of the world.
“The cost-effectiveness of FFR-based PCI was more remarkable for the U.S. healthcare system, which has higher medical costs than the Korean and European healthcare systems,” the authors wrote. “This difference in cost-effectiveness was mainly attributable to relatively higher medical costs incurred when adverse clinical events were treated in the U.S.”
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Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.