Odell Annika, Landelius Per, Astrom-Olsson Karin, Grip Lars
Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Cardiology. 2008;109(2):85-92. doi: 10.1159/000105547. Epub 2007 Aug 3.
The general usage of stents during percutaneous coronary intervention (PCI) reduces the need for subsequent repeated revascularizations when compared with balloon dilatation. The aim was to evaluate the impact of stenting on short- and long-term in-hospital care costs after PCI.
Patients who underwent PCI from July 1992 to June 1993 (group A, n = 166; 4.2% stents) and from July 1996 to June 1997 (group B, n = 233; 61.4% stents) were included. The clinical outcome and all in-hospital care costs during 2.5 years following the procedures were analyzed. During the study period the number of deaths and acute myocardial infarctions was similar in the groups, but repeated revascularization occurred more often in group A than in group B (53.6 vs. 39.5%; p = 0.007). The initial procedural cost per patient was higher in group B than in group A (EUR 7,653 +/- 5,071 vs. EUR 6,048 +/- 3,242; p = 0.002), but after 2.5 years the costs were similar in the 2 groups (not significant).
General usage of stents increases immediate health care cost compared with balloon dilatation, but despite reduction in subsequent revascularization, there is no reduction in long-term in-hospital costs.
与球囊扩张术相比，经皮冠状动脉介入治疗（PCI）期间常规使用支架可减少后续重复血运重建的需求。目的是评估支架置入术对PCI术后短期和长期住院护理费用的影响。
纳入1992年7月至1993年6月接受PCI治疗的患者（A组，n = 166；4.2%使用支架）以及1996年7月至1997年6月接受PCI治疗的患者（B组，n = 233；61.4%使用支架）。分析了术后2.5年内的临床结局和所有住院护理费用。在研究期间，两组的死亡和急性心肌梗死数量相似，但A组重复血运重建的发生率高于B组（53.6%对39.5%；p = 0.007）。B组每位患者的初始手术费用高于A组（7653欧元±5071欧元对6048欧元±3242欧元；p = 0.002），但2.5年后两组费用相似（无显著差异）。
与球囊扩张术相比，常规使用支架会增加直接医疗费用，但尽管后续血运重建减少，长期住院费用并未降低。
