Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma, Omiya, Saitama City, 330-8503, Japan.
Cardiovasc Interv Ther. 2022 Apr;37(2):293-303. doi: 10.1007/s12928-021-00778-3. Epub 2021 Apr 21.
Percutaneous coronary intervention (PCI) is a standard strategy for non-ST-segment elevation myocardial infarction (NSTEMI) as well as for ST-segment elevation myocardial infarction (STEMI). The device cost for PCI may be more expensive in NSTEMI, because the culprit lesion morphology may be more complex in NSTEMI. This study aimed to compare the total device cost of PCI between STEMI and NSTEMI. We included 504 patients with acute myocardial infraction (AMI) who underwent PCI, and divided those into a STEMI group (n = 286) and a NSTEMI group (n = 218). We compared the total device cost, the number of used devices, and procedure cost between the 2 groups. The total device cost was significantly higher in the NSTEMI group [¥371,300 (¥320,700-503,350)] than in the STEMI group [¥341,200 (¥314,200-410,475)] (p = 0.001), whereas the procedure cost was significantly higher in the STEMI group [¥343,800 (¥243,800-343,800)] than in the NSTEMI group [¥220,000 (¥216,800-243,800)] (p < 0.001). Drug eluting stent (85.3% vs. 76.1%, p = 0.029) and aspiration catheter (16.8% vs. 2.3%, p < 0.001) were more frequently used in the STEMI group, whereas rotablator (0.7% vs. 8.3%, p < 0.001) were more frequently used in the NSTEMI group. The multivariate logistic regression analysis revealed that NSTEMI was significantly associated with the high device cost (odds ratio 1.899, 95% confidence interval 1.166-3.093, p = 0.01). In conclusion, the total device cost for PCI was significantly higher in the culprit lesions of NSTEMI than in those of STEMI, whereas the procedure cost was significantly higher in the culprit lesions of STEMI than in those of NSTEMI.
经皮冠状动脉介入治疗（PCI）是治疗非 ST 段抬高型心肌梗死（NSTEMI）和 ST 段抬高型心肌梗死（STEMI）的标准策略。对于 NSTEMI 患者，PCI 的器械费用可能更高，因为 NSTEMI 罪犯病变形态可能更复杂。本研究旨在比较 STEMI 和 NSTEMI 患者 PCI 的总器械费用。我们纳入了 504 例接受 PCI 的急性心肌梗死（AMI）患者，并将其分为 STEMI 组（n=286）和 NSTEMI 组（n=218）。我们比较了两组之间的总器械费用、使用的器械数量和手术费用。NSTEMI 组的总器械费用明显高于 STEMI 组[¥371300（¥320700-503350）]（p=0.001），而 STEMI 组的手术费用明显高于 NSTEMI 组[¥343800（¥243800-343800）]（p<0.001）。药物洗脱支架（85.3%比 76.1%，p=0.029）和抽吸导管（16.8%比 2.3%，p<0.001）在 STEMI 组中更常使用，而旋磨术（0.7%比 8.3%，p<0.001）在 NSTEMI 组中更常使用。多变量逻辑回归分析显示，NSTEMI 与高器械费用显著相关（比值比 1.899，95%置信区间 1.166-3.093，p=0.01）。总之，NSTEMI 罪犯病变的 PCI 总器械费用明显高于 STEMI 罪犯病变，而 STEMI 罪犯病变的手术费用明显高于 NSTEMI 罪犯病变。
