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Targeting patients undergoing angioplasty for thrombus inhibition: a cost-effectiveness and decision support model.

Publication ,  Journal Article
Weintraub, WS; Thompson, TD; Culler, S; Boccuzzi, SJ; Becker, ER; Kosinski, AS; Mahoney, E
Published in: Circulation
July 25, 2000

BACKGROUND: In recent clinical trials, glycoprotein IIb/IIIa blockers have demonstrated effectiveness in preventing adverse events after angioplasty in high-risk patients. However, uncertainty exists regarding the cost-effective selection of patients to receive antiplatelet therapy. METHODS AND RESULTS: All 4962 patients at Emory University Hospitals who underwent coronary intervention procedures (n=6062) from 1993 to 1995 were studied. Multivariate models to predict death and the composite of death, Q-wave and non-Q-wave myocardial infarction, and emergency additional revascularization were developed. Hospital costs and professional costs were determined. A cost-effectiveness analysis with therapy targeted to high-risk patients was performed. If patients with a >5% probability of events received antiplatelet therapy that reduced events by 24% and cost $1000, 40.1% of patients would receive therapy; complications would be reduced from 6.39% to 5.37%, and cost would increase $261 from $10343 to $10604, or $25504 per event prevented. The marginal cost per event prevented by moving from a 7% to a 5% probability of an event cutoff would be $57 799. CONCLUSIONS: For high-risk patients, there may be cost savings; for low-risk patients, therapy may not be cost effective; and for patients in the midrange (between 5% and 7% probability of an adverse event), events may be prevented at an acceptable level of cost.

Duke Scholars

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 25, 2000

Volume

102

Issue

4

Start / End Page

392 / 398

Location

United States

Related Subject Headings

  • Thrombosis
  • Postoperative Complications
  • Platelet Aggregation Inhibitors
  • Multivariate Analysis
  • Models, Statistical
  • Humans
  • Decision Making
  • Cost-Benefit Analysis
  • Cardiovascular System & Hematology
  • Angioplasty
 

Citation

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Weintraub, W. S., Thompson, T. D., Culler, S., Boccuzzi, S. J., Becker, E. R., Kosinski, A. S., & Mahoney, E. (2000). Targeting patients undergoing angioplasty for thrombus inhibition: a cost-effectiveness and decision support model. Circulation, 102(4), 392–398. https://doi.org/10.1161/01.cir.102.4.392
Weintraub, W. S., T. D. Thompson, S. Culler, S. J. Boccuzzi, E. R. Becker, A. S. Kosinski, and E. Mahoney. “Targeting patients undergoing angioplasty for thrombus inhibition: a cost-effectiveness and decision support model.Circulation 102, no. 4 (July 25, 2000): 392–98. https://doi.org/10.1161/01.cir.102.4.392.
Weintraub WS, Thompson TD, Culler S, Boccuzzi SJ, Becker ER, Kosinski AS, et al. Targeting patients undergoing angioplasty for thrombus inhibition: a cost-effectiveness and decision support model. Circulation. 2000 Jul 25;102(4):392–8.
Weintraub, W. S., et al. “Targeting patients undergoing angioplasty for thrombus inhibition: a cost-effectiveness and decision support model.Circulation, vol. 102, no. 4, July 2000, pp. 392–98. Pubmed, doi:10.1161/01.cir.102.4.392.
Weintraub WS, Thompson TD, Culler S, Boccuzzi SJ, Becker ER, Kosinski AS, Mahoney E. Targeting patients undergoing angioplasty for thrombus inhibition: a cost-effectiveness and decision support model. Circulation. 2000 Jul 25;102(4):392–398.

Published In

Circulation

DOI

EISSN

1524-4539

Publication Date

July 25, 2000

Volume

102

Issue

4

Start / End Page

392 / 398

Location

United States

Related Subject Headings

  • Thrombosis
  • Postoperative Complications
  • Platelet Aggregation Inhibitors
  • Multivariate Analysis
  • Models, Statistical
  • Humans
  • Decision Making
  • Cost-Benefit Analysis
  • Cardiovascular System & Hematology
  • Angioplasty