Division of Cardiovascular Medicine, Department of Integrated Medicine I, Jichi Medical University Saitama Medical Center, Omiya, Saitama, Japan.
Catheter Cardiovasc Interv. 2012 Sep 1;80(3):370-6. doi: 10.1002/ccd.23270. Epub 2011 Oct 5.
The purpose of this study was to investigate the association between ACC/AHA type classification of coronary lesions and medical resource utilization.
It is not known whether the classification of coronary lesions by the ACC/AHA system reflects the consumption of medical resources in current percutaneous coronary interventions (PCI).
We identified coronary artery lesions treated with PCI from our PCI database between January 1, 2009 and December 31, 2009. Lesions were classified into type A, type B1, type B2, and type C according to the ACC/AHA definition. Total PCI cost, total contrast volume, and total fluoroscopy time were compared among the groups.
A total of 447 lesions were analyzed. The number of type A, type B1, type B2, and type C lesion were 75 (16.8%), 98 (21.9%), 145 (32.4%), and 129 (28.9%), respectively. Total PCI cost for type A, type B1, type B2, and type C lesions were $7,262 ± 1,397, $8,126 ± 1,891, $9,126 ± 3,128, and $13,243 ± 4,678, respectively (P < 0.0001). Total contrast volume and fluoroscopy time were also stratified according to the order of type A, type B1, type B2, and type C lesions (P < 0.0001 for total contrast volume; P < 0.0001 for total fluoroscopy time).
Total PCI cost, total contrast volume, and total fluoroscopy time were clearly stratified according to the order of type A, type B1, type B2, and type C lesions. Lesion classification by the ACC/AHA system reflects medical resource use in current PCI.
本研究旨在探讨冠状动脉病变的 ACC/AHA 分型与医疗资源利用之间的关系。
目前尚不清楚 ACC/AHA 系统对冠状动脉病变的分类是否反映了当前经皮冠状动脉介入治疗（PCI）中医疗资源的消耗。
我们从 2009 年 1 月 1 日至 2009 年 12 月 31 日的 PCI 数据库中确定了接受 PCI 治疗的冠状动脉病变。根据 ACC/AHA 定义，病变分为 A 型、B1 型、B2 型和 C 型。比较各组之间的总 PCI 费用、总造影剂用量和总透视时间。
共分析了 447 个病变。A 型、B1 型、B2 型和 C 型病变的数量分别为 75（16.8%）、98（21.9%）、145（32.4%）和 129（28.9%）。A 型、B1 型、B2 型和 C 型病变的总 PCI 费用分别为 7262±1397 美元、8126±1891 美元、9126±3128 美元和 13243±4678 美元（P<0.0001）。总造影剂用量和透视时间也根据 A 型、B1 型、B2 型和 C 型病变的顺序进行分层（总造影剂用量 P<0.0001；总透视时间 P<0.0001）。
总 PCI 费用、总造影剂用量和总透视时间均根据 A 型、B1 型、B2 型和 C 型病变的顺序明显分层。ACC/AHA 系统的病变分类反映了当前 PCI 中的医疗资源利用情况。
