| Medical costs and quality of life 10 to 12 years after randomization to angioplasty or bypass surgery for multivessel coronary artery disease. | |
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MedLine Citation:
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PMID: 15451795 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Coronary bypass surgery (CABG) and angioplasty (PTCA) have been compared in several randomized trials, but data about long-term economic and quality-of-life outcomes are limited. METHODS AND RESULTS: Cost and quality-of-life data were collected prospectively from 934 patients who were randomized in the Bypass Angioplasty Revascularization Investigation (BARI) and followed up for 10 to 12 years. CABG had 53% higher costs initially, but the gap closed to <5% during the first 2 years; after 12 years, the mean cumulative cost of CABG patients was 123,000 dollars versus 120,750 dollars for PTCA, yielding a cost-effectiveness ratio of 14,300 dollars/life-year added. CABG patients experienced significantly greater improvement in their physical functioning for the first 3 years but not in later follow-up. Recurrent angina substantially reduced all quality-of-life measures throughout follow-up. Cumulative costs were significantly higher among patients with diabetes, heart failure, and comorbid conditions and among women; costs also were increased by angina, by the number of revascularization procedures, and among patients who died. CONCLUSIONS: Early differences between CABG and PTCA in costs and quality of life were no longer significant at 10 to 12 years of follow-up. CABG was cost-effective as compared with PTCA for multivessel disease. |
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Authors:
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Mark A Hlatky; Derek B Boothroyd; Kathryn A Melsop; Maria M Brooks; Daniel B Mark; Bertram Pitt; Guy S Reeder; William J Rogers; Thomas J Ryan; Patrick L Whitlow; Robert D Wiens |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. Date: 2004-09-27 |
Journal Detail:
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Title: Circulation Volume: 110 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2004 Oct |
Date Detail:
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Created Date: 2004-10-06 Completed Date: 2005-05-27 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1960-6 Citation Subset: AIM; IM |
Affiliation:
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Stanford University School of Medicine, HRP Redwood Building, Room 150, Stanford, CA 94305-5405, USA. hlatky@stanford.edu. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / epidemiology Angioplasty, Transluminal, Percutaneous Coronary / economics, psychology, statistics & numerical data* Comorbidity Coronary Artery Bypass / economics, psychology, statistics & numerical data* Coronary Disease / economics, psychology, surgery, therapy* Coronary Restenosis / epidemiology Cost-Benefit Analysis Disease Progression Employment / statistics & numerical data Female Follow-Up Studies Graft Survival Health Care Costs* Humans Male Middle Aged Prospective Studies Quality of Life Randomized Controlled Trials as Topic Recovery of Function Survival Analysis |
| Comments/Corrections | |
Comment In:
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Circulation. 2005 Apr 5;111(13):e176-7; author reply e176-7
[PMID:
15811864
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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