Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI: Insights from a prospective, randomised study

A. L. Gaster, U. Slothuus Skjoldborg, J. Larsen, L. Korsholm, C. Von Birgelen, S. Jensen, P. Thayssen, K. E. Pedersen, T. H. Haghfelt

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    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.

    Original languageEnglish
    Pages (from-to)1043-1049
    Number of pages7
    JournalHeart
    Volume89
    Issue number9
    DOIs
    Publication statusPublished - 1 Sep 2003

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    Percutaneous Coronary Intervention
    Cost-Benefit Analysis
    Prospective Studies
    Costs and Cost Analysis
    Coronary Angiography
    Stable Angina
    Random Allocation
    Odds Ratio

    Cite this

    Gaster, A. L. ; Slothuus Skjoldborg, U. ; Larsen, J. ; Korsholm, L. ; Von Birgelen, C. ; Jensen, S. ; Thayssen, P. ; Pedersen, K. E. ; Haghfelt, T. H. / Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI : Insights from a prospective, randomised study. In: Heart. 2003 ; Vol. 89, No. 9. pp. 1043-1049.
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    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.",
    author = "Gaster, {A. L.} and {Slothuus Skjoldborg}, U. and J. Larsen and L. Korsholm and {Von Birgelen}, C. and S. Jensen and P. Thayssen and Pedersen, {K. E.} and Haghfelt, {T. H.}",
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    Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI : Insights from a prospective, randomised study. / Gaster, A. L.; Slothuus Skjoldborg, U.; Larsen, J.; Korsholm, L.; Von Birgelen, C.; Jensen, S.; Thayssen, P.; Pedersen, K. E.; Haghfelt, T. H.

    In: Heart, Vol. 89, No. 9, 01.09.2003, p. 1043-1049.

    Research output: Contribution to journalArticleAcademicpeer-review

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    T1 - Continued improvement of clinical outcome and cost effectiveness following intravascular ultrasound guided PCI

    T2 - Insights from a prospective, randomised study

    AU - Gaster, A. L.

    AU - Slothuus Skjoldborg, U.

    AU - Larsen, J.

    AU - Korsholm, L.

    AU - Von Birgelen, C.

    AU - Jensen, S.

    AU - Thayssen, P.

    AU - Pedersen, K. E.

    AU - Haghfelt, T. H.

    PY - 2003/9/1

    Y1 - 2003/9/1

    N2 - 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.

    AB - 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.

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    JF - Heart

    SN - 1355-6037

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