Document Detail


Cost-effectiveness analysis for surgical, angioplasty, or medical therapeutics for coronary artery disease: 5-year follow-up of medicine, angioplasty, or surgery study (MASS) II trial.
MedLine Citation:
PMID:  22965975     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The Second Medicine, Angioplasty, or Surgery Study (MASS II) included patients with multivessel coronary artery disease and normal systolic ventricular function. Patients underwent coronary artery bypass graft surgery (CABG, n=203), percutaneous coronary intervention (PCI, n=205), or medical treatment alone (MT, n=203). This investigation compares the economic outcome at 5-year follow-up of the 3 therapeutic strategies.
METHODS AND RESULTS: We analyzed cumulative costs during a 5-year follow-up period. To analyze the cost-effectiveness, adjustment was made on the cumulative costs for average event-free time and angina-free proportion. Respectively, for event-free survival and event plus angina-free survival, MT presented 3.79 quality-adjusted life-years and 2.07 quality-adjusted life-years; PCI presented 3.59 and 2.77 quality-adjusted life-years; and CABG demonstrated 4.4 and 2.81 quality-adjusted life-years. The event-free costs were $9071.00 for MT; $19,967.00 for PCI; and $18,263.00 for CABG. The paired comparison of the event-free costs showed that there was a significant difference favoring MT versus PCI (P<0.01) and versus CABG (P<0.01) and CABG versus PCI (P=0.01). The event-free plus angina-free costs were $16,553.00, $25,831.00, and $24,614.00, respectively. The paired comparison of the event-free plus angina-free costs showed that there was a significant difference favoring MT versus PCI (P=0.04), and versus CABG (P<0.001); there was no difference between CABG and PCI (P>0.05).
CONCLUSIONS: In the long-term economic analysis, for the prevention of a composite primary end point, MT was more cost effective than CABG, and CABG was more cost-effective than PCI.
CLINICAL TRIAL REGISTRATION INFORMATION: www.controlled-trials.com.
REGISTRATION NUMBER: ISRCTN66068876.
Authors:
Ricardo D'Oliveira Vieira; Whady Hueb; Mark Hlatky; Desiderio Favarato; Paulo Cury Rezende; Cibele Larrosa Garzillo; Eduardo Gomes Lima; Paulo Rogério Soares; Alexandre Ciappina Hueb; Alexandre Costa Pereira; José Antonio Franchini Ramires; Roberto Kalil Filho
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  126     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-11     Completed Date:  2012-11-27     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S145-50     Citation Subset:  AIM; IM    
Data Bank Information
Bank Name/Acc. No.:
ISRCTN/ISRCTN66068876
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / epidemiology
Angioplasty, Balloon, Coronary / economics*,  utilization
Cardiovascular Agents / economics*,  therapeutic use
Coronary Artery Bypass / economics*,  utilization
Coronary Disease / drug therapy,  economics*,  surgery,  therapy
Cost-Benefit Analysis
Diagnostic Techniques, Cardiovascular / economics
Disease-Free Survival
Female
Follow-Up Studies
Health Resources / economics,  statistics & numerical data
Hospitalization / economics,  statistics & numerical data
Humans
Male
Middle Aged
Multicenter Studies as Topic / statistics & numerical data*
Office Visits / economics
Postoperative Complications / economics,  epidemiology
Prospective Studies
Quality-Adjusted Life Years
Randomized Controlled Trials as Topic / statistics & numerical data*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Cardiovascular Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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