{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:49:59Z","timestamp":1784159399360,"version":"3.55.0"},"reference-count":27,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: There are no nationally representative studies of mortality and cost effectiveness for fractional flow reserve (FFR) guided percutaneous coronary interventions (PCI) in patients with cancer. Our study aims to show how this patient population may benefit from FFR-guided PCI. Materials and Methods: Propensity score matched analysis and backward propagation neural network machine learning supported multivariable regression was performed for inpatient mortality in this case-control study of the 2016 National Inpatient Sample (NIS). Regression results were adjusted for age, race, income, geographic region, metastases, mortality risk, and the likelihood of undergoing FFR versus non-FFR PCI. All analyses were adjusted for the complex survey design to produce nationally representative estimates. Results: Of the 30,195,722 hospitalized patients meeting criteria, 3.37% of the PCIs performed included FFR. In propensity score adjusted multivariable regression, FFR versus non-FFR PCI significantly reduced inpatient mortality (OR 0.47, 95%CI 0.35\u20130.63; p &lt; 0.001) and length of stay (LOS) (in days; beta \u22120.23, 95%CI \u22120.37\u2013\u22120.09; p = 0.001) while increasing cost (in USD; beta $5708.63, 95%CI, 3042.70\u20138374.57; p &lt; 0.001), without significantly increasing complications overall. FFR versus non-FFR PCI did not specifically change cancer patients\u2019 inpatient mortality, LOS, or cost. However, FFR versus non-FFR PCI significantly increased inpatient mortality for Hodgkin\u2019s lymphoma (OR 52.48, 95%CI 7.16\u2013384.53; p &lt; 0.001) and rectal cancer (OR 24.38, 95%CI 2.24\u2013265.73; p = 0.009). Conclusions: FFR-guided PCI may be safely utilized in patients with cancer as it does not significantly increase inpatient mortality, complications, and LOS. These findings support the need for an increased utilization of FFR-guided PCI and further studies to evaluate its long-term impact.<\/jats:p>","DOI":"10.3390\/medicina58070859","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T01:48:38Z","timestamp":1656467318000},"page":"859","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Fractional Flow Reserve Cardio-Oncology Effects on Inpatient Mortality, Length of Stay, and Cost Based on Malignancy Type: Machine Learning Supported Nationally Representative Case-Control Study of 30 Million Hospitalizations"],"prefix":"10.3390","volume":"58","author":[{"given":"Siddharth","family":"Chauhan","sequence":"first","affiliation":[{"name":"Department of Cardiology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7671-1886","authenticated-orcid":false,"given":"Dominique J.","family":"Monlezun","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2478-1975","authenticated-orcid":false,"given":"Jin wan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6296-6503","authenticated-orcid":false,"given":"Harsh","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Hanna","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Hoang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Palaskas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Lopez-Mattei","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saamir","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Cilingiroglu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Marmagkiolis","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cezar A.","family":"Iliescu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Health Science Center at Houston, Houston, TX 77030, USA"},{"name":"Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2908","DOI":"10.1001\/jama.293.23.2908","article-title":"Routine vs. selective invasive strategies in patients with acute coronary syndromes: A collaborative meta-analysis of randomized trials","volume":"293","author":"Mehta","year":"2005","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2906","DOI":"10.1161\/CIRCULATIONAHA.104.521864","article-title":"Percutaneous coronary intervention versus conservative 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