Does spinal cord stimulation reduce hospital care costs and morbidity compared to coronary artery bypass grafting in patients with severe angina pectoris and increased surgical risk?
In patients with severe angina and high surgical risk, spinal cord stimulation is a more cost-effective symptomatic treatment than CABG, resulting in fewer hospitalization days and comparable mortality.
The present study is a 2-year follow-up of the 104 patients participating in the ESBY study (Electrical Stimulation versus Coronary Artery Bypass Surgery in Severe Angina Pectoris), a randomised prospective study including patients with increased surgical risk and no prognostic benefit from revascularisation. Hospital care costs, morbidity and causes of death after spinal cord stimulation (SCS) and coronary artery bypass grafting (CABG) were assessed, as well as the complication rate of SCS treatment. SCS proved to be a less expensive symptomatic treatment modality of angina pectoris than CABG (p < 0.01). The SCS group had fewer hospitalisation days related to the primary intervention (p < 0.0001) and fewer hospitalisation days due to cardiac events (p < 0.05). The groups did not differ with regard to causes of death. There were no serious complications related to the SCS treatment.
Andréll et al. (Wed,) studied this question.