Document Detail


Costs and effects of combining stenting and abciximab (ReoPro) in daily practice.
MedLine Citation:
PMID:  11182196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: The combined use of stents and abciximab in percutaneous coronary intervention has been evaluated in the EPISTENT trial. However, the clinical and economic findings in trials are not necessarily generalisable to a general population setting. We conducted a study in daily clinical practice comparing stented and non-stented patients undergoing coronary angioplasty with abciximab administration. Furthermore, we compare our results with the findings of the EPISTENT trial. METHODS: From 1995 to 1999, refractory unstable patients scheduled for angioplasty and receiving abciximab in a Dutch regional hospital were followed prospectively for 6 months. Total costs were considered in addition to 2 composite clinical endpoints: (1) death or myocardial infarction (MI); and (2) death, MI, or any revascularisation procedure (major adverse cardiac events, MACE). RESULTS: Stented patients (N=101) experienced less MACE than non-stented patients (N=83) (6.9% vs. 16.9%, OR=0.37, P=0.04). The total costs were similar for stented and non-stented patients (EUR 7 844 vs. EUR 7 904, P=0.93). Adjustment for baseline characteristics yielded similar results, although significance subsided. The relative risk reduction of 44% that we found, closely resembles the 42% that was found in the EPISTENT trial. CONCLUSIONS: In everyday practice, as in the EPISTENT trial, the addition of a stent to abciximab treatment does seem to reduce the risk of MACE by about 40% at no additional costs.
Authors:
J E Zwart-van Rijkom; O H Klungel; H G Leufkens; A W Broekmans; S Schrijver-van Velthoven; V A Umans
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  77     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2001-02-22     Completed Date:  2001-07-12     Revised Date:  2006-07-12    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  299-303     Citation Subset:  IM    
Affiliation:
Utrecht University, Department of Pharmaco-epidemiology and Pharmacotherapy, Utrecht, The Netherlands. J.E.F.Zwart-vanRijkom@pharm.uu.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Antibodies, Monoclonal / therapeutic use*
Coronary Disease / therapy*
Cost of Illness
Female
Humans
Immunoglobulin Fab Fragments / therapeutic use*
Male
Netherlands
Platelet Glycoprotein GPIIb-IIIa Complex / therapeutic use*
Prospective Studies
Stents* / economics
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 143653-53-6/abciximab

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