FFR-Guided PCI Use Rising
Sharp increase seen in the wake of FAME trial
by Nicole Lou, Reporter, MedPage Today/CRTonline.org February 10, 2016
Fractional flow reserve (FFR) enjoyed a surge in popularity after key trial findings in 2008, a study found.
In an analysis of the Nationwide Inpatient Sample, FFR was used in 21,365 procedures in 2012, up 18-fold from the 1,173 done in 2008 when the FAME trial first showed better outcomes linked to FFR-guided coronary interventions.
Similarly, FFR guidance for percutaneous coronary intervention (PCI) rose 16-fold from 622 in 2008 to 9,945 in 2012, even as total PCI procedures dropped 28.2% over the same period, Naga V. Pothineni, MD, and colleagues found.
"This study demonstrates increased adoption of FFR in clinical practice," they reported in the Journal of the American College of Cardiology, citing the influence of FAME.
One key finding from FAME was that at 1 year, the combined rate of death, myocardial infarction, coronary artery bypass surgery, and repeat PCI was 13.2% in FFR patients, whereas those assessed with angiography had a rate of 18.4% (P=0.02).
In the present study, Pothineni and colleagues found that most of the FFR procedures in 2012 were performed in urban institutions, with 59.2% taking place in urban teaching hospitals and 33.6% in urban nonteaching hospitals.
Their analysis did not look specifically at use of virtual FFR measurement via noninvasive FFR CT imaging, which was recently shown to boost cost-effectiveness and quality of life compared with standard diagnostic angiography in PLATFORM trial analyses.
Pothineni reported no relevant conflicts of interest.
Journal of the American College of Cardiology
Source Reference: Pothineni NV et al "U.S. trends in inpatient utilization of fractional flow reserve and percutaneous coronary intervention" J Am Coll Cardiol 2016; DOI: 10.1016/j.jacc.2015.11.042