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Acta Biomed ; 89(3): 378-381, 2018 10 08.
Article in English | MEDLINE | ID: mdl-30333462

ABSTRACT

BACKGROUND AND AIM: Applying fractional flow reserve (FFR) recently helped to assess borderline coronary defects and also facilitates assessment of these lesions. The present study aimed to assess cost-effectiveness of FFR in detection of these borderline lesions. METHODS: This cross-sectional study was conducted on140 consecutive patients with 219 diseased arteries who underwent coronary angiography and suffered intermediate coronary lesions. RESULTS: Of 18 patients who candidate for CABG before FFR, only one patient underwent CABG after determining FFR (P-value<0.05), while 15 patients were scheduled for PCI and 2 patients for medical treatment. Of 122 patients who candidate for PCI, 59 were programmed to underwent PCI after FFR determination(P-value<0.05), while the strategy in 63 patients (47 with one-vessel disease, 15 with two vessel diseases, and 1 with three vessel diseases) was modified to medical treatment. Considering strategy modifying from PCI to medical treatment, 101 stents were saved (P-value<0.05). Also, in change of strategy from CABG to PCI, spending has decreased as much as 77.3% (P-value<0.05). Furthermore, the change of treatment approach from PCI on much number of coronary vessels to PCI on less number of coronary lesions led to saving of 52.2% of costs(P-value<0.05). CONCLUSIONS: In patients with an intermediate coronary lesion, measuring FFR to guide the decision to determine treatment strategy may lead to significant cost savings.


Subject(s)
Coronary Artery Disease/physiopathology , Fractional Flow Reserve, Myocardial , Adult , Aged, 80 and over , Cardiovascular Agents/therapeutic use , Clinical Decision-Making , Coronary Artery Bypass , Coronary Artery Disease/economics , Coronary Artery Disease/epidemiology , Coronary Artery Disease/therapy , Cost Savings , Cost-Benefit Analysis , Cross-Sectional Studies , Dyslipidemias/epidemiology , Female , Humans , Hypertension/epidemiology , Male , Middle Aged , Percutaneous Coronary Intervention , Pilot Projects , Severity of Illness Index , Smoking/epidemiology
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