title: Clinical usefulness and cost effectiveness of fractional flow reserve among Indian patients (FIND study).
abstract: OBJECTIVE
  To study the clinical usefulness, cost benefit, and medium term outcome of fractional flow reserve (FFR) based management of coronary artery disease of intermediate severity.
  
  
  BACKGROUND
  In spite of the advantages of FFR there is paucity of data in Indian population who have frequent diffuse, small and multivessel disease where it would probably be more beneficial in terms of cost and outcome.
  
  
  METHODS
  The treating cardiologist's management decision with both FFR and angiographic data was compared with that of a reviewing cardiologist decision based on a retrospective analysis of angiogram alone.
  
  
  RESULTS
  Eighty-one vessels with intermediate lesions in 59 patients required 26 stents lesser when FFR data was added to the angiogram. The concordance of management decision was about 58% which means that >40% of intermediate lesions would be misclassified as significant based on angiography alone. There were no major events at a mean follow up of 11 ± 5 months. The net cost benefit in favor of FFR based management was INR 8,57,600 (USD 15,600) in our centre.
  
  
  CONCLUSIONS
  Indians with more severe form of CAD benefit from a FFR based management plan for intermediate lesions, both clinically and economically. © 2014 Wiley Periodicals, Inc.
authors.affiliation: Senior Consultant and Interventional cardiologist, Department of cardiology, Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India.
authors.forename: G
authors.initials: G
authors.lastname: Sengottuvelu
authors.affiliation: Interventional cardiologist, SS Heart & Skin Care Hospital, Kallakurichi, Tamil Nadu, India.
authors.forename: Babu
authors.initials: B
authors.lastname: Chakravarthy
authors.affiliation: Associate Consultant, Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India.
authors.forename: Ravindran
authors.initials: R
authors.lastname: Rajendran
authors.affiliation: Research Assistant, Apollo Hospitals, Greams Road, Chennai, Tamil Nadu, India.
authors.forename: Sreyes
authors.initials: S
authors.lastname: Ravi
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000191:economics / Q000453:epidemiology / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000191:economics*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents
keywords: cost benefit; fractional flow reserve; intermediate lesions; multivessel disease