The prognostic value and economic benefits of coronary angiography-derived fractional flow reserve-guided strategy in patients with coronary artery disease

Zhenzhou Zhang; Mengshi Xie; Xixi Dai; Zhiyong Duan; Zhiren Lu; Liangyin Cai; Rongrong Gu; Lei Shen; Zhong Xu; Weifeng Yao; Yunfei Liu; Minlei Liao; Hongyu Shi

doi:10.1016/j.heliyon.2023.e17464

The prognostic value and economic benefits of coronary angiography-derived fractional flow reserve-guided strategy in patients with coronary artery disease

Heliyon. 2023 Jun 22;9(6):e17464. doi: 10.1016/j.heliyon.2023.e17464. eCollection 2023 Jun.

Authors

Zhenzhou Zhang¹, Mengshi Xie¹, Xixi Dai¹, Zhiyong Duan¹, Zhiren Lu², Liangyin Cai³, Rongrong Gu¹, Lei Shen¹, Zhong Xu¹, Weifeng Yao¹, Yunfei Liu¹, Minlei Liao¹, Hongyu Shi¹

Affiliations

¹ Department of Cardiology, Zhongshan Hospital Wusong Branch, Fudan University, 200094, China.
² Medical Emergency Center of Baoshan District, Shanghai, 201901, China.
³ Department of Pharmacy, Wusong Hospital of Zhongshan Hospital, Fudan University, 200094, China.

Abstract

Objective: This study aims to investigate the prognostic value and economic benefit of coronary angiography-derived fractional flow reserve (caFFR) guided percutaneous coronary intervention (PCI) in patients with coronary artery disease.

Methods: All patients with coronary artery disease (CAD) who underwent coronary angiography in our center between April 2021 and November 2021 were retrospectively enrolled and divided into the caFFR guidance group (n = 160) and angiography guidance group (n = 211). A threshold of caFFR≤0.8 was used for revascularization. Otherwise, delayed PCI was preferred. The patients were prospectively followed up by telephone or outpatient service at six months for major adverse cardiovascular events (MACE) of all-cause death, myocardial infarction or target vessel revascularization, stent thrombosis, and stroke. All in-hospital expenses were recorded, including initial hospitalization and re-hospitalization related to MACE.

Results: There was no significant difference in the baseline characteristics between the two groups. There were 2 (1.2%) patients in the caFFR guidance group and 5 (2.4%) patients in the angiography guidance group with MACE events during the following six months. Compared with angiography guidance, caFFR guidance reduced the revascularization rate (63.7% vs. 84.4%, p = 0.000), the average length of stents implanted (0.52 ± 0.88 vs. 1.1 ± 1.4, P < 0.001). The cost of consumables in the caFFR guidance group was significantly lower than that in the angiography guidance group (33257 ± 19595 CNY vs. 38341 ± 16485 CNY, P < 0.05).

Conclusion: Compared with coronary angiography guidance, caFFR guidance is of great significance in reducing revascularization and cost, which has significant health and economic benefits.

Keywords: Coronary angiography; Coronary angiography-derived fractional flow reserve; Coronary artery disease; Health economic benefits; Percutaneous coronary intervention; Prognostic level.