Abstract 18105: National Utilization Rates of Fractional Flow Reserve in Guiding Coronary Revascularization
Background: Fractional flow reserve (FFR) is a well-validated and cost effective method for guiding coronary revascularization, however, the national utilization rates of FFR in United States are unknown.
Methods: The Nationwide Inpatient Sample (NIS) database was used to identify patients who underwent FFR guided coronary revascularization in United States from January to December 2009. We evaluated FFR utilization rates across various demographic profiles including geographic location, hospital types and payers. Statistical analysis included chi-square test for categorical variables and t-test for continuous variables.
Results: Among a total of 722,585 patients who underwent coronary revascularization, 8,287 (1.2%) patients underwent FFR. The in-hospital mortality in FFR group was 0.4%. There was marked heterogeneity in FFR utilization rates across various states ranging from <0.1% to 2.2%. FFR utilization rates were significantly lower in males versus females (1.1% vs. 1.3%, p < 0.01), Whites versus African Americans (1.1% vs. 1.2%, p < 0.01), and in non-teaching versus teaching hospitals (1.1% vs. 1.2%, p = 0.03). The utilization rates were higher among patients with Medicaid as compared to Medicare or private insurance payers (1.6% vs. 1.3% vs. 1.3%, p <0.01) and in rural rather than urban hospitals (1.5% vs. 1.1%, p <0.01).
Conclusion: In this observational study we found that FFR guided coronary revascularization is highly underutilized in United States and there is marked heterogeneity across the nation in utilization of this technology.
- © 2012 by American Heart Association, Inc.