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Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China.

Publication ,  Journal Article
Jin, C; Li, W; Qiao, S-B; Yang, J-G; Wang, Y; He, P-Y; Tang, X-R; Dong, Q-T; Li, X-D; Yan, H-B; Wu, Y-J; Chen, J-L; Gao, R-L; Yuan, J-Q ...
Published in: J Am Heart Assoc
April 22, 2016

BACKGROUND: Transradial percutaneous coronary intervention (PCI) has been increasingly adopted in clinical practice, given its potential advantages over transfemoral intervention; however, the impact of different access strategies on costs and clinical outcomes remains poorly defined, especially in the developing world. METHODS AND RESULTS: Using data from a consecutive cohort of 5306 patients undergoing PCI in China in 2010, we compared total hospital costs and in-hospital outcomes for transradial intervention (TRI) and transfemoral intervention. Patients receiving TRI (n=4696, 88.5%) were slightly younger (mean age 57.4 versus 59.5 years), less often women (21.6% versus 33.1%), more likely to undergo PCI for single-vessel disease, and less likely to undergo PCI for triple-vessel or left main diseases. The unadjusted total hospital costs were 57 900 Chinese yuan (¥57 900; equivalent to 9190 US dollars [$9190]) for TRI and ¥67 418 ($10,701) for transfemoral intervention. After adjusting for all observed patient and procedural characteristics using the propensity score inverse probability weighting method, TRI was associated with a lower total cost (adjusted difference ¥8081 [$1283]). More than 80% of the cost difference was related to lower PCI-related costs (adjusted difference -¥5162 [-$819]), which were likely driven by exclusive use of vascular closure devices in transfemoral intervention, and lower hospitalization costs (-¥1399 [-$222]). Patients receiving TRI had shorter length of stay and were less likely to experience major adverse cardiac events or post-PCI bleeding. These differences were consistent among clinically relevant subgroups with acute myocardial infarction, acute coronary syndrome, and stable angina. CONCLUSIONS: Among patients undergoing PCI, TRI was associated with lower cost and favorable clinical outcomes compared with transfemoral intervention.

Duke Scholars

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Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

April 22, 2016

Volume

5

Issue

4

Location

England

Related Subject Headings

  • Retrospective Studies
  • Radial Artery
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Male
  • Humans
  • Hospital Costs
  • Follow-Up Studies
  • Femoral Artery
  • Female
 

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Jin, C., Li, W., Qiao, S.-B., Yang, J.-G., Wang, Y., He, P.-Y., … Yang, Y.-J. (2016). Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China. J Am Heart Assoc, 5(4). https://doi.org/10.1161/JAHA.115.002684
Jin, Chen, Wei Li, Shu-Bin Qiao, Jin-Gang Yang, Yang Wang, Pei-Yuan He, Xin-Ran Tang, et al. “Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China.J Am Heart Assoc 5, no. 4 (April 22, 2016). https://doi.org/10.1161/JAHA.115.002684.
Jin C, Li W, Qiao S-B, Yang J-G, Wang Y, He P-Y, et al. Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China. J Am Heart Assoc. 2016 Apr 22;5(4).
Jin, Chen, et al. “Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China.J Am Heart Assoc, vol. 5, no. 4, Apr. 2016. Pubmed, doi:10.1161/JAHA.115.002684.
Jin C, Li W, Qiao S-B, Yang J-G, Wang Y, He P-Y, Tang X-R, Dong Q-T, Li X-D, Yan H-B, Wu Y-J, Chen J-L, Gao R-L, Yuan J-Q, Dou K-F, Xu B, Zhao W, Zhang X, Xian Y, Yang Y-J. Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China. J Am Heart Assoc. 2016 Apr 22;5(4).
Journal cover image

Published In

J Am Heart Assoc

DOI

EISSN

2047-9980

Publication Date

April 22, 2016

Volume

5

Issue

4

Location

England

Related Subject Headings

  • Retrospective Studies
  • Radial Artery
  • Percutaneous Coronary Intervention
  • Middle Aged
  • Male
  • Humans
  • Hospital Costs
  • Follow-Up Studies
  • Femoral Artery
  • Female