Key result
Stenting during PCI is linked to a ~26% reduction in repeated revascularization without lowering long-term costs.
Why the study?
The impact of general stent usage during PCI on short- and long-term in-hospital care costs was not well evaluated.
Does the general usage of stents during PCI reduce short- and long-term in-hospital care costs compared to balloon dilatation?
Cohort (n=399)
Does the general usage of stents during PCI reduce short- and long-term in-hospital care costs compared to balloon dilatation?
Absolute Event Rate: 39.5% vs 53.6%
p-value: p=0.007
General usage of stents during PCI increases initial procedural costs but does not reduce long-term in-hospital costs over 2.5 years, despite significantly reducing the need for repeated revascularization.
Stent use in PCI raises initial costs without long-term savings; leaves open cost-effectiveness versus balloon angioplasty in routine cohorts.
BACKGROUND: The general usage of stents during percutaneous coronary intervention (PCI) reduces the need for subsequent repeated revascularizations when compared with balloon dilatation. The aim was to evaluate the impact of stenting on short- and long-term in-hospital care costs after PCI. METHOD AND RESULTS: Patients who underwent PCI from July 1992 to June 1993 (group A, n = 166; 4.2% stents) and from July 1996 to June 1997 (group B, n = 233; 61.4% stents) were included. The clinical outcome and all in-hospital care costs during 2.5 years following the procedures were analyzed. During the study period the number of deaths and acute myocardial infarctions was similar in the groups, but repeated revascularization occurred more often in group A than in group B (53.6 vs. 39.5%; p = 0.007). The initial procedural cost per patient was higher in group B than in group A (EUR 7,653 +/- 5,071 vs. EUR 6,048 +/- 3,242; p = 0.002), but after 2.5 years the costs were similar in the 2 groups (not significant). CONCLUSION: General usage of stents increases immediate health care cost compared with balloon dilatation, but despite reduction in subsequent revascularization, there is no reduction in long-term in-hospital costs.
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Odell et al. (2007) conducted a cohort in Percutaneous coronary intervention (n=399). General usage of stents vs. Balloon dilatation (low stent usage) was evaluated on Repeated revascularization (p=0.007). General usage of stents during PCI reduced repeated revascularization (39.5% vs 53.6%; P=0.007) and increased initial costs, but did not reduce long-term in-hospital costs at 2.5 years.
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