Tags

Type your tag names separated by a space and hit enter

Comparison of multiple drug-eluting stent percutaneous coronary intervention and surgical revascularization in patients with multivessel coronary artery disease: one-year clinical results and total treatment costs.
J Invasive Cardiol. 2007 Nov; 19(11):469-75.JI

Abstract

PURPOSE

Consecutive patients with multivessel coronary artery disease treated with multiple drug-eluting-stent (DES) percutaneous coronary intervention (PCI) (111 patients) or coronary artery bypass graft (CABG) (95 patients) on the basis of clinico-anatomical judgment were examined to investigate mediumterm clinical results and initial and total costs.

METHODS

Clinical and procedural characteristics, duration of hospital stay, initial and total costs and 12-month follow-up events were considered in both groups.

RESULTS

Previous revascularization procedures and acute coronary syndromes were more frequent in the PCI group, while triple-vessel and left main disease occurred more often in the CABG group. The mean number of treated vessels in multiple DES PCI was 2.7/patient, with 2.8 DES/patient. Complete revascularization was achieved in 70% of cases. Inhospital events were postprocedural non-Q-wave acute myocardial infarction in 5.4%, and 2 retroperitoneal hemorrhages. CABG was performed with a mean of 3.9 grafts/patient; 16 patients (17%) had early complications; mean hospital stay was significantly longer than for the PCI patients (23.5 +/- 10 vs. 5.3 +/- 3 days; p < 0.001). Twelve-month total mortality and acute myocardial infarction incidents were similar, while target vessel revascularization was significantly more frequent in the PCI group (12.6% PCI vs. 2.1% CABG; p < 0.001); cumulative major adverse cardiac events were not significantly different (15.3% PCI vs. 9.5% CABG; p = 0.271). Initial and final costs were lower for multivessel PCI with DES (20,050 +/- 2,702 for CABG vs. 10,214 +/- 4,184 for PCI; p < 0.001), but not completely covered by current DRG reimbursement.

CONCLUSIONS

Multiple DES PCI showed good earlyand medium-term results with substantially lower costs than CABG.

Authors+Show Affiliations

Department of Cardiologo, Ospedale S. Maria delle Croci, Viale Randi, 5, 48100, Ravenna, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article

Language

eng

PubMed ID

17986722

Citation

Varani, Elisabetta, et al. "Comparison of Multiple Drug-eluting Stent Percutaneous Coronary Intervention and Surgical Revascularization in Patients With Multivessel Coronary Artery Disease: One-year Clinical Results and Total Treatment Costs." The Journal of Invasive Cardiology, vol. 19, no. 11, 2007, pp. 469-75.
Varani E, Balducelli M, Vecchi G, et al. Comparison of multiple drug-eluting stent percutaneous coronary intervention and surgical revascularization in patients with multivessel coronary artery disease: one-year clinical results and total treatment costs. J Invasive Cardiol. 2007;19(11):469-75.
Varani, E., Balducelli, M., Vecchi, G., Aquilina, M., & Maresta, A. (2007). Comparison of multiple drug-eluting stent percutaneous coronary intervention and surgical revascularization in patients with multivessel coronary artery disease: one-year clinical results and total treatment costs. The Journal of Invasive Cardiology, 19(11), 469-75.
Varani E, et al. Comparison of Multiple Drug-eluting Stent Percutaneous Coronary Intervention and Surgical Revascularization in Patients With Multivessel Coronary Artery Disease: One-year Clinical Results and Total Treatment Costs. J Invasive Cardiol. 2007;19(11):469-75. PubMed PMID: 17986722.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of multiple drug-eluting stent percutaneous coronary intervention and surgical revascularization in patients with multivessel coronary artery disease: one-year clinical results and total treatment costs. AU - Varani,Elisabetta, AU - Balducelli,Marco, AU - Vecchi,Giuseppe, AU - Aquilina,Matteo, AU - Maresta,Aleardo, PY - 2007/11/8/pubmed PY - 2008/1/8/medline PY - 2007/11/8/entrez SP - 469 EP - 75 JF - The Journal of invasive cardiology JO - J Invasive Cardiol VL - 19 IS - 11 N2 - PURPOSE: Consecutive patients with multivessel coronary artery disease treated with multiple drug-eluting-stent (DES) percutaneous coronary intervention (PCI) (111 patients) or coronary artery bypass graft (CABG) (95 patients) on the basis of clinico-anatomical judgment were examined to investigate mediumterm clinical results and initial and total costs. METHODS: Clinical and procedural characteristics, duration of hospital stay, initial and total costs and 12-month follow-up events were considered in both groups. RESULTS: Previous revascularization procedures and acute coronary syndromes were more frequent in the PCI group, while triple-vessel and left main disease occurred more often in the CABG group. The mean number of treated vessels in multiple DES PCI was 2.7/patient, with 2.8 DES/patient. Complete revascularization was achieved in 70% of cases. Inhospital events were postprocedural non-Q-wave acute myocardial infarction in 5.4%, and 2 retroperitoneal hemorrhages. CABG was performed with a mean of 3.9 grafts/patient; 16 patients (17%) had early complications; mean hospital stay was significantly longer than for the PCI patients (23.5 +/- 10 vs. 5.3 +/- 3 days; p < 0.001). Twelve-month total mortality and acute myocardial infarction incidents were similar, while target vessel revascularization was significantly more frequent in the PCI group (12.6% PCI vs. 2.1% CABG; p < 0.001); cumulative major adverse cardiac events were not significantly different (15.3% PCI vs. 9.5% CABG; p = 0.271). Initial and final costs were lower for multivessel PCI with DES (20,050 +/- 2,702 for CABG vs. 10,214 +/- 4,184 for PCI; p < 0.001), but not completely covered by current DRG reimbursement. CONCLUSIONS: Multiple DES PCI showed good earlyand medium-term results with substantially lower costs than CABG. SN - 1557-2501 UR - https://www.unboundmedicine.com/medline/citation/17986722/Comparison_of_multiple_drug_eluting_stent_percutaneous_coronary_intervention_and_surgical_revascularization_in_patients_with_multivessel_coronary_artery_disease:_one_year_clinical_results_and_total_treatment_costs_ L2 - http://www.invasivecardiology.com/article/7953 DB - PRIME DP - Unbound Medicine ER -