Analysis of the Relative Costs and Effectiveness of Primary Angioplasty Versus Tissue-Type Plasminogen Activator: The Primary Angioplasty in Myocardial Infarction (PAMI) Trial
| Autor: | Donald Rothbaum, Gregg W. Stone, Bryan Donohue, Noah Chelliah, Tom Catlin, Ronald E. Vlietstra, Cindy L. Grines, Paul Overlie, William W. O'Neill, Kevin F. Browne, James H. O'Keefe |
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| Rok vydání: | 1997 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment medicine.disease law.invention Clinical trial Randomized controlled trial law Internal medicine Angioplasty medicine Cardiology cardiovascular diseases Myocardial infarction business Prospective cohort study Cardiology and Cardiovascular Medicine Plasminogen activator TIMI Cardiac catheterization |
| Zdroj: | Journal of the American College of Cardiology. 29(5):901-907 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/s0735-1097(97)00041-7 |
| Popis: | Objectives. We sought to determine the relative cost and effectiveness of two different reperfusion modalities in patients with acute myocardial infarction (AMI). Background. Recent studies have found superior clinical outcomes after reperfusion by primary percutaneous transluminal coronary angioplasty (PTCA) compared with thrombolytic therapy. The high up-front costs of cardiac catheterization may diminish the relative advantages of this invasive strategy. Methods. Detailed in-hospital charge data were available from all 358 patients with AMI randomized to tissue-type plasminogen activator (t-PA) or primary PTCA in the United States from the Primary Angioplasty in Myocardial Infarction trial. Resource consumption during late follow-up was estimated by assessment of major clinical events and functional status. Results. Compared with t-PA, primary PTCA resulted in reduced rates of in-hospital mortality (2.3% vs. 7.2%, p = 0.03), reinfarction (2.8% vs. 7.2%, p = 0.06), recurrent ischemia (11.3% vs. 28.7%, p Conclusions. Compared with t-PA, reperfusion by primary PTCA improves clinical outcomes with similar or reduced costs. These findings have important clinical implications in an increasingly cost-conscious health care environment. (J Am Coll Cardiol 1997;29:901–7) © 1997 by the American College of Cardiology |
| Databáze: | OpenAIRE |
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