Background Coronary stenting has been shown to improve initial success, reduce angiographic restenosis, and reduce the need for repeat revascularization compared with conventional balloon angioplasty (PTCA).
Although previous studies have demonstrated that initial hospital costs for stenting are considerably higher than those for conventional PTCA, the impact of coronary stenting on long-term medical care costs remains unknown.
Methods and Results Between January 1991 and June 1993,207 consecutive patients with symptomatic coronary disease requiring revascularization of a single coronary lesion were randomized to receive initial treatment by either PTCA (n=105) or Palmaz-Schatz coronary stent implantation (n=102) in the multicenter STRESS trial.
Compared with conventional angioplasty, coronary stenting resulted in additional catheterization laboratory costs, increased vascular complications, and longer length of stay.
Elective coronary stenting, as performed in the randomized STRESS trial, increased total 1-year medical care costs by $800 per patient compared with conventional angioplasty.
Future studies will be necessary to determine whether ongoing refinements in stent design, implantation techniques, and anticoagulation regimens can narrow this cost difference further by reducing stent-related vascular complications or length of stay.
Mots-clés Pascal : Dilatation instrumentale, Artère coronaire, Endoprothèse, Analyse avantage coût, Economie santé, Etude longitudinale, Traitement, Homme, Traitement instrumental
Mots-clés Pascal anglais : Instrumental dilatation, Coronary artery, Endoprosthesis, Cost benefit analysis, Health economy, Follow up study, Treatment, Human, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0021190
Code Inist : 002B26E. Création : 01/03/1996.