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Titolo:
Primary PTCA versus thrombolysis with tPA in acute myocardial infarction: a formal cost-effectiveness analysis
Autore:
Mullner, M; Paulis, M; Nikfardjam, M; Domanovits, H; Huber, K;
Indirizzi:
Univustriaa, Vienna Gen Hosp, Sch Med, Dept Emergency Med, A-1090 Vienna, A Univ Vienna Vienna Austria A-1090 , Dept Emergency Med, A-1090 Vienna, A Univ Vienna, Vienna Gen Hosp, Sch Med, Dept Cardiol, A-1090 Vienna, Austria Univ Vienna Vienna Austria A-1090 , Dept Cardiol, A-1090 Vienna, Austria
Titolo Testata:
WIENER KLINISCHE WOCHENSCHRIFT
fascicolo: 1, volume: 111, anno: 1999,
pagine: 37 - 41
SICI:
0043-5325(19990115)111:1<37:PPVTWT>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
PRIMARY ANGIOPLASTY; IMMEDIATE ANGIOPLASTY; PLASMINOGEN-ACTIVATOR; THERAPY; REINFARCTION; MORTALITY; TRIAL;
Keywords:
acute myocardial infarction; thrombolysis; tPA; percutaneous transluminal coronary angioplasty; cost-effectiveness;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
18
Recensione:
Indirizzi per estratti:
Indirizzo: Mullner, M Univ Vienna, Vienna Gen Hosp, Sch Med, Dept Emergency Med, Wahringer Gurtel Univ Vienna Wahringer Gurtel 18-20-6D Vienna Austria A-1090 el
Citazione:
M. Mullner et al., "Primary PTCA versus thrombolysis with tPA in acute myocardial infarction: a formal cost-effectiveness analysis", WIEN KLIN W, 111(1), 1999, pp. 37-41

Abstract

Aims: Information concerning the cost-effectiveness of primary percutaneous transluminal coronary angioplasty (PTCA) compared to thrombolytic treatment with tissue plasminogen activator (tPA) for the management of acute myocardial infarction (AMI) is limited. The existing data are derived from studies using a wide range of intervention, re-intervention and a high rate of mortality. The present study examined the cost-effectiveness of primary PTCA compared to thrombolytic treatment with tPA in the setting of AMI by applying data from published prospective randomised studies. Methods and results: We performed a formal cost effectiveness analysis. Asestimates for "cost" of therapy we applied the reimbursement paid by the public health insurance organisations in Austria. Coronary intervention rates and re-intervention rates were extracted from published studies. Assuminga moderately reduced in-hospital mortality for patients treated with primary PTCA (4.8%) compared to tPA (6.6%) on the basis of AMI in a 60-year-old male, the estimated additional cost per life saved was 274.- ECU (95% confidence interval 231.- to 318.- ECU). However, the cost per life saved was sensitive to the given range of intervention and re-intervention rates (range2,518.- ECU gain to 9,560.- ECU additional cost). Conclusions: Assuming a moderate in-hospital survival benefit from treatment with primary PTCA in patients with AMI, PTCA seems to be cost effective in comparison to treatment with tPA - at least from the perspective of costreimbursement by public health insurance organisations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/04/20 alle ore 19:24:02