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Real-World Evaluation of a Pharmacoinvasive Strategy for STEMI in Latin America: A Cost-Effective Approach with Short-Term Benefits.
- Source :
-
Therapeutics and clinical risk management [Ther Clin Risk Manag] 2023 Nov 10; Vol. 19, pp. 903-911. Date of Electronic Publication: 2023 Nov 10 (Print Publication: 2023). - Publication Year :
- 2023
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Abstract
- Purpose: While pharmacoinvasive strategy (PI) is a safe and effective approach whenever access to primary percutaneous intervention (pPCI) is limited, data on each strategy's economic cost and impact on in-hospital stay are scarce. The objective is to compare the cost-effectiveness of a PI with that of pPCI for the treatment of ST-elevation myocardial infarction (STEMI) in a Latin-American country.<br />Patients and Methods: A total of 1747 patients were included, of whom 470 (26.9%) received PI, 433 (24.7%) pPCI, and 844 (48.3%) NR. The study's primary outcome was the incremental cost-effectiveness ratio (ICER) for PI compared with those for pPCI and non-reperfused (NR), calculated for 30-day major cardiovascular events (MACE), 30-day mortality, and length of stay.<br />Results: For PI, the ICER estimates for MACE showed a decrease of $-35.81/per 1% (95 confidence interval, -114.73 to 64.81) compared with pPCI and a decrease of $-271.60/per 1% (95% CI, -1086.10 to -144.93) compared with NR. Also, in mortality, PI had an ICER decrease of $-129.50 (95% CI, -810.57, 455.06) compared to pPCI and $-165.27 (-224.06, -123.52) with NR. Finally, length of stay had an ICER reduction of -765.99 (-4020.68, 3141.65) and -283.40 (-304.95, -252.76) compared to pPCI and NR, respectively.<br />Conclusion: The findings of this study suggest that PI may be a more efficient treatment approach for STEMI in regions where access to pPCI is limited or where patient and system delays are expected.<br />Competing Interests: Dr Alexandra Arias-Mendoza reports personal fees from Boehringer, personal fees from Novartis, personal fees from Novonordisk, outside the submitted work. The authors report no other conflicts of interest in this work.<br /> (© 2023 Arias-Mendoza et al.)
Details
- Language :
- English
- ISSN :
- 1176-6336
- Volume :
- 19
- Database :
- MEDLINE
- Journal :
- Therapeutics and clinical risk management
- Publication Type :
- Academic Journal
- Accession number :
- 38023623
- Full Text :
- https://doi.org/10.2147/TCRM.S432683