Greenberg Dan, Bakhai Ameet, Cohen David J
Harvard Clinical Research Institute, Boston, Massachusetts, USA.
J Am Coll Cardiol. 2004 Feb 18;43(4):513-8. doi: 10.1016/j.jacc.2003.11.020.
Over the past decade, coronary stenting has emerged as the dominant form of percutaneous coronary revascularization. However, bare metal stents remain limited by a high incidence of restenosis, leading to frequent repeat revascularization procedures and substantial economic burden. Antiproliferative drug-eluting stents (DES) have recently demonstrated dramatic reductions in rates of restenosis, compared with conventional stenting, but important concerns about their costs have been raised. In this article, we summarize current evidence on the economic impact of restenosis and explore the potential benefits and economic outcomes of DES. In addition to examining the long-term costs of this promising technology, we consider the potential cost-effectiveness of DES from a health care system perspective and the impact of specific patient, lesion, and provider characteristics on these parameters.
在过去十年中，冠状动脉支架置入术已成为经皮冠状动脉血运重建的主要形式。然而，裸金属支架仍受再狭窄高发生率的限制，导致频繁进行重复血运重建手术并带来巨大经济负担。与传统支架置入术相比，抗增殖药物洗脱支架（DES）最近已显示出再狭窄率大幅降低，但人们对其成本提出了重要担忧。在本文中，我们总结了关于再狭窄经济影响的当前证据，并探讨了DES的潜在益处和经济结果。除了研究这项有前景技术的长期成本外，我们还从医疗保健系统的角度考虑DES的潜在成本效益，以及特定患者、病变和医疗服务提供者特征对这些参数的影响。
