Trends and predictors of Fractional Flow Reserve use among patients with myocardial infarction in the United States
Presenter
Osarenren Idemudia, MD, Rochester Regional Health, Rochester, NY, NY
Osarenren Idemudia, MD1, Onovughe Aroriode, MBBS1, Achint Patel2, Tarilate Aroriode1 and Mohammed Syed1, (1)Rochester Regional Health, Rochester, NY, NY, (2)Icahn School of Medicine at Mount Sinai, Frisco, NY
Keywords: Acute Coronary Syndromes (ACS), Coronary and Imaging & Physiology
Background
There is a paucity of data on the trends and predictors of Fractional Flow Reserve (FFR) use. Our study aimed to determine the trend and predictors of FFR use during coronary angiography in patients with myocardial infarction.
Methods
We derived a study cohort from Nationwide Inpatient Sample (NIS) for the years 2010-2017. Adult Hospitalizations with PCI and FFR were identified using International Classification of Diseases (9th/10th Editions) Clinical Modification diagnosis codes (ICD-9-CM/ICD-10-CM). We utilized Cochran Armitage trend test and multivariable survey logistic regression models to analyze the trends, predictors, and outcomes.
Results
A total of 4,003,839 patients underwent PCI, of which FFR was utilized among 106,127 (2.7%) patients. The utilization trend of FFR increased significantly from 0.8% in 2010 to 4.6% in 2017 (p:<0.001). Among those who received FFR, 51.2% were > 65 years of age, 66.0% were male and 76.1% were Caucasians. FFR was associated with lower rates of in-hospital mortality (0.9% vs 2.4%; p:<0.001) and discharge to facilities (5.4% vs 7.0%; p:<0.001). In multivariable regression analysis, insurance status, demographics, and hospital region were significantly associated with discrepancies in FFR utilization. The predictor of FFR utilization has been detailed in figure 1.
Conclusions
Our study showed that between 2010-2017 the use of FFR during coronary angiography increased significantly. There was a demographic and socioeconomic disparity in the FFR utilization. These findings may not necessarily be causative but raise the important issues that need to be further investigated.
