Key result
Cytosorb during CABG with ticagrelor is linked to ~€2670 added cost per patient.
Why the study?
Patients with acute coronary syndrome on ticagrelor undergoing coronary artery bypass grafting face high perioperative bleeding risk, and the cost-revenue impact of using a haemoadsorbent membrane to mitigate this risk was unclear.
Does the Cytosorb haemoadsorbent membrane improve budget impact in patients with acute coronary syndrome requiring coronary artery bypass graft surgery while on ticagrelor?
Cohort (n=40)
No
Does the Cytosorb haemoadsorbent membrane improve budget impact in patients with acute coronary syndrome requiring coronary artery bypass graft surgery while on ticagrelor?
Using the Cytosorb haemoadsorbent membrane during CABG for patients on ticagrelor increases overall costs in the French healthcare system, despite reducing ICU length of stay.
Increases net costs in French hospitals despite higher revenue and shorter ICU stays; leaves open cost-effectiveness pending randomized data.
BACKGROUND: Patients with acute coronary syndrome requiring coronary artery bypass graft surgery while on ticagrelor face a high risk of perioperative bleeding because of its strong antiplatelet effect. The Cytosorb® haemoadsorbent membrane (CytoSorbents Corporation, Princeton, NJ, USA), which is CE marked for ticagrelor removal, may help to mitigate this risk. AIM: To evaluate the cost-revenue impact of the use of Cytosorb® membrane over two different time periods in a high-volume French hospital. METHODS: A retrospective cohort of patients who underwent coronary artery bypass grafting with ticagrelor without the use of Cytosorb® and a prospective cohort of patients of the same type undergoing coronary artery bypass grafting with the use of Cytosorb® were compared. The primary outcome was the budget impact of using Cytosorb® in patients undergoing coronary artery bypass grafting with ticagrelor. Secondary outcomes included morbidity criteria and the length of stay in different hospital departments. RESULTS: Among 40 patients, the cost difference favoured the cohort without Cytosorb® by €2670. However, the Cytosorb® group generated €635 more revenue per patient. Operative variables (duration, cardiopulmonary bypass time, transfusions) were similar, but the Cytosorb® group had a shorter stay in the intensive care unit. Sensitivity analysis highlighted membrane cost as the most influential factor in the overall cost difference. CONCLUSION: In the French financial context, the use of the Cytosorb® in coronary artery bypass graft surgery with ticagrelor leads to additional costs, despite a slight revenue increase and the potential benefit of a shorter stay in the intensive care unit.
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Mathat et al. (2025) conducted a cohort in Acute coronary syndrome requiring coronary artery bypass graft surgery while on ticagrelor (n=40). Cytosorb haemoadsorbent membrane vs. No Cytosorb membrane was evaluated on Budget impact of using Cytosorb. Using the Cytosorb haemoadsorbent membrane during CABG with ticagrelor resulted in an additional cost of €2670 per patient compared to no membrane, despite generating €635 more revenue.
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