Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI: insights from a prospective, randomised study
Open Access
- 1 September 2003
- Vol. 89 (9), 1043-1049
- https://doi.org/10.1136/heart.89.9.1043
Abstract
Objective: To investigate in a prospective randomised study both long term clinical effects and cost effectiveness of percutaneous coronary interventions (PCI) with or without intravascular ultrasound (IVUS) guidance. Methods: 108 male patients with stable angina referred for PCI of a significant coronary lesion were randomly assigned to IVUS guided PCI or conventional PCI. Individual accumulated costs of the entire follow up period were calculated and compared in the randomisation groups. Effectiveness of treatment was measured by freedom from major adverse cardiac events. Results: Cost effectiveness of IVUS guided PCI that was noted at six months was maintained and even accentuated at long term follow up (median 2.5 years). The cumulated cost level was found to be lower for the IVUS guided group, with a cumulated cost of &163 672 in the IVUS guided group versus &313 706 in the coronary angiography group (p = 0.01). Throughout the study, mean cost per day was lower in the IVUS guided PCI group (&2.7 v &5.2; p = 0.01). In the IVUS group, 78% were free from major adverse cardiac events versus 59% in the coronary angiography group (p = 0.04) with an odds ratio of 2.5 in favour of IVUS guidance. Conclusion: IVUS guidance results in continued improvement of long term clinical outcome and cost effectiveness. The results of this study suggest that IVUS guidance may be used more liberally in PCI.Keywords
This publication has 23 references indexed in Scilit:
- Does early repolarization in the athlete have analogies with the Brugada syndrome?Published by Oxford University Press (OUP) ,2001
- Cost-effectiveness Analysis of Intravascular Ultrasound Guided Percutaneous Coronary Intervention versus Conventional Percutaneous Coronary InterventionScandinavian Cardiovascular Journal, 2001
- An explanation for discrepancy between angiographic and intravascular ultrasound measurements after percutaneous transluminal coronary angioplastyJournal of the American College of Cardiology, 1995
- Intracoronary two-dimensional ultrasound imaging in the assessment of plaque morphologic features and the planning of coronary interventionsAmerican Heart Journal, 1995
- Benefit of intracoronary ultrasound in the deployment of Palmaz-Schatz stentsJournal of the American College of Cardiology, 1994
- Clinical applications of Doppler coronary flow reserve measurementsThe American Journal of Cardiology, 1993
- Arterial wall characteristics determined by intravascular ultrasound imaging: An in vitro studyJournal of the American College of Cardiology, 1989
- Potential errors in the estimation of coronary arterial stenosis from clinical arteriography with reference to the shape of the coronary arterial lumen.Heart, 1986
- Amount of narrowing by atherosclerotic plaque in 44 nonbypassed and 52 bypassed major epicardial coronary arteries in 32 necropsy patients who died within 1 month of aortocoronary bypass graftingThe American Journal of Cardiology, 1980
- Correlation of the Antemortem Coronary Arteriogram and the Postmortem SpecimenCirculation, 1973