Related Experiment Video
Updated: Jan 17, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Adjunctive Imaging and Physiology During Percutaneous Coronary Intervention: Trends, Outcomes, and Costs Among
Frank A Medina1, Ramya C Mosarla2, Joseph M Kim3
1Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA; University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA.
Background:
The dual use of intravascular imaging (IVI) and invasive physiology (IP) during percutaneous coronary intervention (PCI) is not well described in the United States.
Objectives:
The aim of this study was to measure trends, clinical outcomes, and costs associated with the use of IVI and IP, alone and together, during PCI.
Methods:
Medicare fee-for-service claims were used to analyze trends in the use of IVI and/or IP during PCI from 2016 to 2023. Beneficiaries ≥65 years of age with a first PCI during the study period were included in the outcomes analysis. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of myocardial infarction, repeat revascularization, and all-cause death at 2 years. Multivariable Cox proportional regression was used to assess outcomes. Gamma regression was used to assess costs.
Results:
A total of 2,538,154 PCIs were performed in 1,958,990 patients from 2016 to 2023. After exclusion, a total of 1,587,532 patients were included in the analysis. Overall, IVI was used in about 15%, IP in 7%, and dual IVI and IP in 2.5% of all PCIs. By 2023, the use of IVI and dual IVI and IP increased to about 30% and 4.7%, respectively. Dual IVI and IP was associated with lower rates of MACE at 2 years compared with angiography alone (adjusted HR: 0.87; 95% CI: 0.85-0.89; P < 0.0001). The cost analysis showed higher upfront procedural costs but lower long-term costs associated with any use of IVI and/or IP.
Conclusions:
The dual use of IVI and IP has marginally increased and was associated with lower MACE and long-term costs compared with angiography alone.
More Related Videos
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:27Coronary Artery Disease V: Interprofessional Care
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...