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New tool for heart disease saves both lives and money

Increased use of a new interventional cardiology tool that can help patients avoid needless artery-opening stents has been found to not only save lives but save money as well, according to today's story in Inside Stanford Medicine.

William Fearon, MD, first author of the study, was quoted in the story as saying, "This is one of those rare situations in which a new technology not only improves outcomes but also saves resources."

The cost-comparison study is a follow-up to a 2009 clinical trial that compared the use of angiogram alone to the use of "fractional flow reserve," or FFR. FFR involves inserting a coronary pressure guidewire into the arteries to measure blood pressure beyond the narrowing of the artery to help determine whether a stent is necessary. The New England Journal of Medicine study found that the additional use of the pressure wire resulted in one-third fewer stents with improved patient outcomes. Fearon was co-principal investigator and senior author of that multicenter international study called FAME.

Since publication of the "FAME" study, use of the pressure wire has increased 15 percent by clinicians, Fearon said in an interview.

"It's still not as high as appropriate, but it's still a pretty dramatic increase," Fearon said. "At Stanford we were already using it a fair amount, but now my colleagues are using it more."

In the cost-comparison study, researchers found that savings over a one-year period averaged $2,000, reducing costs from $14,000 to $12,000. The savings were due to fewer stents and fewer follow-up events in patients such as heart attacks, blood clots and repeat surgeries. Stents cost about $2,000, while the pressure wire runs about $650.

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