Cost-Effectiveness of Sirolimus-Eluting Stents for Treatment of Complex Coronary Stenoses
| العنوان: | Cost-Effectiveness of Sirolimus-Eluting Stents for Treatment of Complex Coronary Stenoses |
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| المؤلفون: | Ronna H. Berezin, Tara A. Lavelle, Louise Githiora, Richard E. Kuntz, Joseph P. Carrozza, James P. Zidar, David J. Cohen, Chunxue Shi, Jeffrey W. Moses, Ameet Bakhai, Martin B. Leon |
| المصدر: | Circulation. 110:508-514 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2004. |
| سنة النشر: | 2004 |
| مصطلحات موضوعية: | Male, Bare-metal stent, Cardiac Catheterization, medicine.medical_specialty, Ticlopidine, Percutaneous, Cost effectiveness, Cost-Benefit Analysis, medicine.medical_treatment, Drug Costs, Coronary Restenosis, Double-Blind Method, Restenosis, Physiology (medical), Internal medicine, Diabetes Mellitus, Myocardial Revascularization, medicine, Humans, Angioplasty, Balloon, Coronary, Hospital Costs, Sirolimus, business.industry, Percutaneous coronary intervention, Equipment Design, Health Care Costs, Middle Aged, medicine.disease, United States, Clopidogrel, Surgery, Treatment Outcome, medicine.anatomical_structure, Bypass surgery, Cardiology, Health Resources, Female, Stents, Quality-Adjusted Life Years, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, Follow-Up Studies, Artery, medicine.drug |
| الوصف: | Background— Recently, sirolimus-eluting stents (SESs) have been shown to dramatically reduce the risk of angiographic and clinical restenosis compared with bare metal stent (BMS) implantation. However, the overall cost-effectiveness of this strategy is unknown. Methods and Results— Between February and August 2001, 1058 patients with complex coronary stenoses were enrolled in the SIRIUS trial and randomized to percutaneous coronary revascularization with either a SES or BMS. Clinical outcomes, resource use, and costs were assessed prospectively for all patients over a 1-year follow-up period. Initial hospital costs were increased by $2881 per patient with SESs. Over the 1-year follow-up period, use of SESs led to substantial reductions in the need for repeat revascularization, including repeat percutaneous coronary intervention and bypass surgery. Although follow-up costs were reduced by $2571 per patient with SESs, aggregate 1-year costs remained $309 per patient higher. The incremental cost-effectiveness ratio for SES was $1650 per repeat revascularization event avoided or $27 540 per quality-adjusted year of life gained, values that compare reasonably with other accepted medical interventions. Under updated treatment assumptions regarding available stent lengths and duration of antiplatelet therapy, use of SESs was projected to reduce total 1-year costs compared with BMSs. Conclusions— Although use of SESs was not cost-saving compared with BMS implantation, for patients undergoing percutaneous coronary intervention of complex coronary stenoses, their use appears to be reasonably cost-effective within the context of the US healthcare system. |
| تدمد: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.0000136821.99814.43 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f0448a75270169bc277d5a931f41bc28 https://doi.org/10.1161/01.cir.0000136821.99814.43 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f0448a75270169bc277d5a931f41bc28 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15244539 00097322 |
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| DOI: | 10.1161/01.cir.0000136821.99814.43 |