Cost-effective analysis of the fractional flow reserve in an iranian cohort with multivessel coronary artery disease

Bakhshandeh, H. and Noohi, F. and Sadeghipour, P. and Esfahani, S. and Basiri, H.A. and Zahedmehr, A. and Shafe, O. and Beheshti, A.T. and Alilou, S. and Behroozifar, Z. and Sedigh, H. and Moosavi, J. (2020) Cost-effective analysis of the fractional flow reserve in an iranian cohort with multivessel coronary artery disease. Iranian Heart Journal, 21 (3). pp. 64-72.

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Background: The fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has proven effective in decreasing cardiac events by comparison with all-comers stenting. In this study, we aimed to evaluate the cost-effectiveness of this method in an Iranian population. Methods: In this prospective cohort, patients with moderate stenosis (50�70 severity) were included, while those with acute coronary syndrome were excluded. The patients were divided into 2 groups: the FFR group, for whom revascularization was performed based on FFR results, and the control group, for whom revascularization was performed based on the interventionist�s assessment. An FFR of less than 0.80 was considered ischemic in this investigation. Results: A total of 188 patients with moderate coronary artery lesions scheduled for elective PCI were included: 98 patients were assigned to the FFR group and 90 to the control group. Readmission and major adverse cardiac events (MACE) were decreased significantly in the FFR group (24.4 vs 11.2; P = 0.017 and 25.6 vs 12.2; P = 0.019, respectively). The quality-adjusted life-year (QALY) value was improved in the FFR group in comparison with the control group (0.8643 ± 0.0961 vs 0.7449 ± 0.10139, respectively; P < 0.001), resulting in a lower cost for each QALY in the FFR group than in the control group (131 395 349 QALY/rials vs 210 666 667 QALY/rials, respectively; P < 0.001). Additionally, our calculation of the incremental cost-effectiveness ratio showed that the cost-effectiveness of the FFR utilization was at least 409 million rials and at most 431 million rials for each QALY, depending on the inclusion of the cost of the FFR catheter. Conclusions: Our results demonstrated the effectiveness of FFR in diminishing MACE. The method was cost-effective according to various calculation methods in an Iranian population. (Iranian Heart Journal 2020; 21(3): 64-72). © 2020, Iranian Heart Association. All rights reserved.

Item Type: Article
Additional Information: cited By 0
Uncontrolled Keywords: acute coronary syndrome; adult; Article; catheterization; clinical evaluation; cohort analysis; comparative study; coronary artery disease; coronary artery pressure; cost effectiveness analysis; disease severity; female; follow up; fractional flow reserve; health care utilization; hospital readmission; human; incidence; Iran; major adverse cardiac event; major clinical study; male; middle aged; mortality; paraclinical care; percutaneous coronary intervention; pharmaceutical care; prospective study; quality of life; questionnaire; revascularization; visual analog scale
Subjects: WG Cardiovascular System
Depositing User: eprints admin
Date Deposited: 17 May 2021 08:16
Last Modified: 17 May 2021 08:17

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