Trends in use of intravascular pressure measurement of coronary arteries in the US between 2010-2014.

Background
Physiologic approach to intermediate coronary lesions is fast approaching a standard of care. This study was performed to recognize demographic features and analyze the current trends in use of intravascular pressure measurement of coronary arteries in the US between 2010-2014 utilizing the NIS database.

Methods
Nationwide Inpatient Sample (NIS) data was used to extract data of patients undergoing IFR/FFR procedure during index admission for years 2010-2014. Patients were identified by ICD-9 procedure code 00.59 representing Intravascular pressure measurement of coronary arteries. Demographic features and trends in IFR/FFR use over the five year period were analyzed.

Results
A total of 101, 470 indexed procedures of IFR/FFR were performed. Of all patients 63% were males and 37% were females. There is a constant upward trend in the use of intravascular pressure measurement. The number of procedures increased 2.66 fold at the end of 2014 comparing to 2010. The procedure was performed most often in patients aged 65-84 year-old (48%). The main insurance was Medicaid (56%). Majority of the procedures were performed in large (66.75%), urban teaching hospitals (60.9%). IFR/FFR technique was introduced to rural hospitals in 2012 and the number of indexed procedure remains relatively stable representing only 5.37% of all cases. Geographically, the procedure was performed most commonly in southern state in the US (36.4%).

Conclusions
The use of the intravascular pressure measurement of coronary arteries have increased significantly from 2010 to 2014. It is anticipated that the upward trend will continue as we have evidence from FAME, FAME I, and FAME II trial supporting its use.