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Outcomes of fractional flow reserve‐guided percutaneous coronary interventions in patients with acute coronary syndrome
Author(s) -
Omran Jad,
Enezate Tariq,
Abdullah Obai,
AlDadah Ashraf,
Walters Daniel,
Patel Mitul,
Reeves Ryan,
Mahmud Ehtisham
Publication year - 2020
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28611
Subject(s) - medicine , fractional flow reserve , percutaneous coronary intervention , cardiology , conventional pci , acute coronary syndrome , revascularization , coronary artery disease , stroke (engine) , population , myocardial infarction , coronary angiography , mechanical engineering , environmental health , engineering
Fractional flow reserve (FFR) assessment has been validated as an effective tool to guide revascularization of stable coronary artery disease. The role of utilizing FFR in acute coronary syndrome (ACS) is less established. Methods The study population was extracted from the National Readmissions Data (NRD) 2014 using International Classification of Diseases, ninth edition, clinical modification (ICD‐9‐CM) codes for ACS, percutaneous coronary intervention (PCI), FFR, and periprocedural complications. Study endpoints included all‐cause of in‐hospital mortality, length of index hospital stay (LOS), acute kidney injury (AKI), bleeding, coronary dissection, total number of stents used, stroke, vascular complications (VCs), and the total charges of index hospitalization. Results A total of 304,548 discharges that had the diagnosis of ACS and treated invasively within the same index hospitalization (average age 65.1 years; 64% male) were identified. Among these, 7,832 had FFR guided invasive treatment (2.6%) which was associated with significantly lower in‐hospital all‐cause mortality (1.1 vs. 3.1%, p < .01), shorter LOS (4.6 vs. 5.3 days, p < .01), less AKI (12.5 vs. 14.6%, p < .01), less bleeding (7.0 vs. 8.5%, p < .01), and lower total charges ($99,805 vs. $105,736). There was no significant difference between both groups in terms of stroke (2.2 vs. 2.3%, p = .41), coronary dissection (0.7 vs. 0.8%, p = .34), VC (1.3 vs. 1.0% p = .01) or the total number of stents used (55.5 vs. 54.5% p = .34). Conclusion In patients presenting with an ACS FFR‐ guided PCI, as compared to angiography guided PCI, was associated with lower rates of in‐hospital mortality, shorter LOS, less AKI, bleeding and lower hospital charges. There was no significant difference in terms of the incidence of stroke, coronary dissection, VC or the total number of stents used.