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  • Aasa, MikaelKarolinska Institutet,Karolinska Institute (author)

Cost and health outcome of primary percutaneous coronary intervention versus thrombolysis in acute ST-segment elevation myocardial infarction-Results of the Swedish Early Decision reperfusion Study (SWEDES) trial.

  • Article/chapterEnglish2010

Publisher, publication year, extent ...

  • Elsevier BV,2010

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/130429
  • https://gup.ub.gu.se/publication/130429URI
  • https://doi.org/10.1016/j.ahj.2010.05.008DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:121105091URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-8101URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-58795URI

Supplementary language notes

  • Language:English

Part of subdatabase

Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • BACKGROUND: In ST-elevation myocardial infarction, primary percutaneous coronary intervention (PCI) has a superior clinical outcome, but it may increase costs in comparison to thrombolysis. The aim of the study was to compare costs, clinical outcome, and quality-adjusted survival between primary PCI and thrombolysis. METHODS: Patients with ST-elevation myocardial infarction were randomized to primary PCI with adjunctive enoxaparin and abciximab (n = 101), or to enoxaparin followed by reteplase (n = 104). Data on the use of health care resources, work loss, and health-related quality of life were collected during a 1-year period. Cost-effectiveness was determined by comparing costs and quality-adjusted survival. The joint distribution of incremental costs and quality-adjusted survival was analyzed using a nonparametric bootstrap approach. RESULTS: Clinical outcome did not differ significantly between the groups. Compared with the group treated with thrombolysis, the cost of interventions was higher in the PCI-treated group ($4,602 vs $3,807; P = .047), as well as the cost of drugs ($1,309 vs $1,202; P = .001), whereas the cost of hospitalization was lower ($7,344 vs $9,278; P = .025). The cost of investigations, outpatient care, and loss of production did not differ significantly between the 2 treatment arms. Total cost and quality-adjusted survival were $25,315 and 0.759 vs $27,819 and 0.728 (both not significant) for the primary PCI and thrombolysis groups, respectively. Based on the 1-year follow-up, bootstrap analysis revealed that in 80%, 88%, and 89% of the replications, the cost per health outcome gained for PCI will be <$0, $50,000, and $100,000 respectively. CONCLUSION: In a 1-year perspective, there was a tendency toward lower costs and better health outcome after primary PCI, resulting in costs for PCI in comparison to thrombolysis that will be below the conventional threshold for cost-effectiveness in 88% of bootstrap replications.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Henriksson, MartinLinköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet(Swepub:liu)marhe38 (author)
  • Dellborg, Mikael,1954Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xdelmi (author)
  • Grip, Lars,1952Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xgrila (author)
  • Herlitz, Johan,1949Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,[external](Swepub:hb)jhz (author)
  • Levin, Lars-Åke,1960Linköpings universitet,Utvärdering och hälsoekonomi,Hälsouniversitetet(Swepub:liu)larle77 (author)
  • Svensson, LeifKarolinska Institutet,Stockholm Prehospital Centre (author)
  • Janzon, MagnusÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken(Swepub:liu)magja75 (author)
  • Karolinska InstitutetKarolinska Institute (creator_code:org_t)

Related titles

  • In:American heart journal: Elsevier BV160:2, s. 322-81097-67440002-8703

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