Cost analysis of non-invasive fractional flow reserve derived from coronary computed tomographic angiography in Japan

Takeshi Kimura, Hiroki Shiomi, Sachio Kuribayashi, Takaaki Isshiki, Susumu Kanazawa, Hiroshi Ito, Shunya Ikeda, Ben Forrest, Christopher K. Zarins, Mark A. Hlatky, Bjarne L. Norgaard

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Percutaneous coronary intervention (PCI) based on fractional flow reserve (FFRcath) measurement during invasive coronary angiography (CAG) results in improved patient outcome and reduced healthcare costs. FFR can now be computed non-invasively from standard coronary CT angiography (cCTA) scans (FFRCT). The purpose of this study is to determine the potential impact of non-invasive FFRCT on costs and clinical outcomes of patients with suspected coronary artery disease in Japan. Clinical data from 254 patients in the HeartFlowNXT trial, costs of goods and services in Japan, and clinical outcome data from the literature were used to estimate the costs and outcomes of 4 clinical pathways: (1) CAG-visual guided PCI, (2) CAG-FFRcath guided PCI, (3) cCTA followed by CAG-visual guided PCI, (4) cCTA-FFRCT guided PCI. The CAG-visual strategy demonstrated the highest projected cost ($10,360) and highest projected 1-year death/myocardial infarction rate (2.4 %). An assumed price for FFRCT of US $2,000 produced equivalent clinical outcomes (death/MI rate: 1.9 %) and healthcare costs ($7,222) for the cCTA-FFRCT strategy and the CAG-FFRcath guided PCI strategy. Use of the cCTA-FFRCT strategy to select patients for PCI would result in 32 % lower costs and 19 % fewer cardiac events at 1 year compared to the most commonly used CAG-visual strategy. Use of cCTA-FFRCT to select patients for CAG and PCI may reduce costs and improve clinical outcome in patients with suspected coronary artery disease in Japan.

Original languageEnglish
Pages (from-to)38-44
Number of pages7
JournalCardiovascular Intervention and Therapeutics
Volume30
Issue number1
DOIs
Publication statusPublished - Jan 1 2014

Keywords

  • Computational fluid dynamics
  • Coronary computed tomographic angiography
  • Cost-effectiveness
  • Fractional flow reserve
  • Non-invasive diagnosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Cost analysis of non-invasive fractional flow reserve derived from coronary computed tomographic angiography in Japan'. Together they form a unique fingerprint.

  • Cite this

    Kimura, T., Shiomi, H., Kuribayashi, S., Isshiki, T., Kanazawa, S., Ito, H., Ikeda, S., Forrest, B., Zarins, C. K., Hlatky, M. A., & Norgaard, B. L. (2014). Cost analysis of non-invasive fractional flow reserve derived from coronary computed tomographic angiography in Japan. Cardiovascular Intervention and Therapeutics, 30(1), 38-44. https://doi.org/10.1007/s12928-014-0285-1