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Fractional flow reserve (FFR) guided coronary revascularization has been shown to have superior clinical outcomes when compared to angiographic guidance alone in randomized clinical trials, however, national outcomes in patients undergoing FFR guided revascularization are unknown.
The 2008–2009 Nationwide Inpatient Sample (NIS) database was used to identify patients who underwent both FFR and angiographic guided revascularization in the United States. Nearest–neighbor propensity score matching using the Elixhauser comorbidity risk index, patient demographics, and hospital characteristics was performed for comorbidity adjustment. In–hospital outcomes and resource utilization among the matched group of patients that underwent FFR versus angiographic guided coronary revascularization was performed.
A propensity score matched cohort of 3,428 patients with 1,714 in each group was identified. The FFR group had a non–significant trend towards lower in–hospital mortality as compared to the angiographic group (0.4% vs. 0.8%, p = 0.07). The FFR group had significantly lower lengths of stay (3.4 vs. 4.5 days, p < 0.01) and hospital charges ($62,637 vs. $77,751 p < 0.01). The rates of coronary dissection (1.1% vs. 1.1%, p = 0.87), procedure–related cardiac complications (2.2% vs. 2.6%, p = 0.44), procedure–related stroke (0.3% vs. 0.3%, p = 1.0), peripheral vascular complications (0.6% vs. 0.8%, p = 0.55), procedural hemorrhage (0.7% vs. 1.3%, p = 0.09) and hematoma formation (1.9% vs. 2.0%, p = 0.80) were similar between the two groups.
In this observational study, we found that FFR guided coronary revascularization is associated with significantly lower hospital charges and length of stay when compared to angiographic guided revascularization. There was no associated increase in procedure related morbidity and there was a trend towards lower in–hospital mortality in those who underwent FFR.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Coronary Stents
Abstract Category: 47. TCT@ACC–i2: Coronary Intervention, Devices
Presentation Number: 2101–237
- 2013 American College of Cardiology Foundation