Multivessel Coronary Artery Disease
Conditions
Keywords
multivessel coronary artery disease, drug-eluting stent, CABG, cost-effectiveness
Brief summary
The objective of the present study is to analyze the cost-effectiveness of percutaneous coronary intervention (PCI) using TAXUS stents compared to the costs of coronary artery bypass surgery (CABG) in patients with multivessel coronary artery disease (CAD) in the first 5 years and then 10 years after intervention. Multivessel PCI or CABG was performed in 114 or 93 patients, respectively. Clinical outcomes, in terms of incidence of acute myocardial infarction (AMI), all-cause death, target vessel revascularization (TVR) and stroke, resource use and costs are analyzed prospectively over a 5 and 10-year follow-up (FUP) period. Overall costs consist of the baseline costs of the index procedure (PCI or CABG), clinical and angiographic procedure-related treatments during the entire FUP. The primary endpoint is cost-effectiveness and clinical effectiveness, defined as the reduction of the composite of major adverse cardiac and cerebrovascular events (MACCE).
Interventions
PROCEDUREcomparison of PCI vs. CABG in multivessel disease
invasive treatment of coronary artery disease
Sponsors
Medical University of Vienna
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* two or three-vessel disease requiring percutaneous or surgical multivessel intervention with the aim of complete revascularization * age \> 18 years * clinical symptoms (stable or unstable angina) or signs of myocardial ischemia * ≥ 50% diameter stenosis of each lesion
Exclusion criteria
* acute myocardial infarction (\< 48 h); * contraindications to clopidogrel, aspirin, heparin and taxol; * pregnancy or lack of protection against pregnancy or breast-feeding during the study; * hemorrhagic diathesis and platelet count \<100.000/ml3
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Cost-effectiveness of percutaneous coronary intervention with Taxus stents compared to CABG in patients with multivessel coronary artery disease. | in-hospital phase (up to 3 weeks) |
Secondary
| Measure | Time frame |
|---|---|
| Occurrence of MACCE, defined as cardiac death, nonfatal myocardial infarction, target vessel revascularization and stroke | 6 months |
| Rate of target vessel revascularization | 6 months |
| Occurrence of non-fatal acute myocardial infarction | 6 months |
| Occurrence of cardiac death | 6 months |
| Calculation of the total costs | in-hospital phase (up to 3 weeks) |
Countries
Austria
Outcome results
None listed