| Primary angioplasty is cost-minimizing compared with pre-hospital thrombolysis for patients within 60 min of a percutaneous coronary intervention center: the Comparison of Angioplasty and Pre-hospital Thrombolysis in Acute Myocardial Infarction (CAPTIM) cost-efficacy sub-study. | |
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MedLine Citation:
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PMID: 15708697 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: This ancillary study of the Comparison of Angioplasty and Pre-hospital Thrombolysis in Acute Myocardial Infarction (CAPTIM) trial sought to assess the cost-efficacy ratio of primary coronary angioplasty (PCA) and pre-hospital thrombolysis (PHT) in patients suffering from an acute myocardial infarction (AMI) (<6 h) close to (<60 min journey) a percutaneous coronary intervention (PCI) center. BACKGROUND: In the CAPTIM study, at 30 days follow-up PCA was as equally effective as PHT with rescue angioplasty if needed. The cost efficacy of these two strategies has not yet been compared. METHODS: Data were prospectively collected for 299 patients in three centers. The efficacy analysis was extended at one-year follow-up for those patients. Direct fixed and variable actual costs were assessed with a piggyback data collection. RESULTS: The one-year primary end point event-rate (death, non-fatal myocardial infarction, and stroke) was not different after PCA or PHT (14% vs. 16. 4%, p = NS). Costs were lower in the PCA group either during the in-hospital period (8,287 vs. 9,170 $, p = 0.0001) and after one-year follow-up, in relation to a higher rate of subsequent revascularizations in the PHT group (49% vs. 23%, p < 0. 01), leading to a longer hospital stay (10 vs. 9.1 days, p = 0. 03). CONCLUSIONS: After AMI in patients less than 1 h from a PCI center, PCA is as effective and less costly than a combined strategy of PHT followed by rescue angioplasty. |
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Authors:
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Jacques Machecourt; Eric Bonnefoy; Gérald Vanzetto; Pascal Motreff; Stéphanie Marlière; Alain Leizorovicz; Benoit Allenet; Jean Michel Lacroute; Jean Cassagnes; Paul Touboul |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 45 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2005 Feb |
Date Detail:
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Created Date: 2005-02-14 Completed Date: 2005-03-17 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 515-24 Citation Subset: AIM; IM |
Affiliation:
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Coronary Care Unit, CHU Grenoble, Grenoble, France. JMachecourt@chu-grenoble.fr <JMachecourt@chu-grenoble.fr> |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary
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economics* Coronary Care Units Costs and Cost Analysis Emergency Medical Services / economics* Female Humans Male Middle Aged Myocardial Infarction / economics*, therapy* Prospective Studies Thrombolytic Therapy / economics* Time Factors |
| Comments/Corrections | |
Comment In:
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Nat Clin Pract Cardiovasc Med. 2005 Aug;2(8):390-1
[PMID:
16119698
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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