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Economic implications of the prophylactic use of intraaortic balloon counterpulsation in the setting of acute myocardial infarction. The Randomized IABP Study Group. Intraaortic Balloon Pump.

Publication ,  Journal Article
Talley, JD; Ohman, EM; Mark, DB; George, BS; Leimberger, JD; Berdan, LG; Davidson-Ray, L; Rawert, M; Lam, LC; Phillips, HR; Califf, RM
Published in: Am J Cardiol
March 1, 1997

Intraaortic balloon counterpulsation (IABP) has been shown to improve coronary artery patency and reduce the rates of recurrent myocardial ischemia and its sequelae in selected patients when used within 24 hours of acute myocardial infarction. The economic implications of prophylactic IABP use are unknown. We obtained hospital bills for 102 patients enrolled in the Randomized IABP Trial (56%) and converted charges to costs using each hospital's Medicare cost report. In-hospital costs for patients who had 48 hours of IABP were compared with those of patients who did not. The costs of angiographic and clinical complications were determined. Small differences in clinical and angiographic characteristics existed between patients in the economic substudy and the overall population, but overall angiographic and clinical outcomes were comparable. Costs for patients who had IABP versus control patients were similar: mean $22,357 +/- $14,369 versus $19,211 +/- $8,414, median (25th and 75th percentiles) $17,903 ($15,787, $22,147) versus $17,913 ($15,144, $21,433), p = 0.45. Hospital costs were higher with the development of recurrent ischemia: mean $23,125 +/- $7,690 versus $20,416 +/- $12,449, median $21,069 ($17,896, $26,885) versus $17,492 ($14,892, $20,998) p = 0.02. Patients who had an adverse clinical event (death, stroke, reinfarction, and emergency revascularization) also had higher hospital costs: mean $25,598 +/- $10,024 versus $19,790 +/- $12,045, median $21,877 ($18,380, $28,049) versus $17,364 ($14,773, $20,779), p = 0.002. The prophylactic use of IABP in patients at high risk of infarct artery reocclusion within 24 hours of acute myocardial infarction provides sustained clinical benefit without substantially increasing hospital costs.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

March 1, 1997

Volume

79

Issue

5

Start / End Page

590 / 594

Location

United States

Related Subject Headings

  • Vascular Patency
  • United States
  • Treatment Outcome
  • Risk Factors
  • Recurrence
  • Myocardial Revascularization
  • Myocardial Ischemia
  • Myocardial Infarction
  • Middle Aged
  • Medicare
 

Citation

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ICMJE
MLA
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Talley, J. D., Ohman, E. M., Mark, D. B., George, B. S., Leimberger, J. D., Berdan, L. G., … Califf, R. M. (1997). Economic implications of the prophylactic use of intraaortic balloon counterpulsation in the setting of acute myocardial infarction. The Randomized IABP Study Group. Intraaortic Balloon Pump. Am J Cardiol, 79(5), 590–594. https://doi.org/10.1016/0002-9149(96)00821-1
Talley, J. D., E. M. Ohman, D. B. Mark, B. S. George, J. D. Leimberger, L. G. Berdan, L. Davidson-Ray, et al. “Economic implications of the prophylactic use of intraaortic balloon counterpulsation in the setting of acute myocardial infarction. The Randomized IABP Study Group. Intraaortic Balloon Pump.Am J Cardiol 79, no. 5 (March 1, 1997): 590–94. https://doi.org/10.1016/0002-9149(96)00821-1.
Talley JD, Ohman EM, Mark DB, George BS, Leimberger JD, Berdan LG, Davidson-Ray L, Rawert M, Lam LC, Phillips HR, Califf RM. Economic implications of the prophylactic use of intraaortic balloon counterpulsation in the setting of acute myocardial infarction. The Randomized IABP Study Group. Intraaortic Balloon Pump. Am J Cardiol. 1997 Mar 1;79(5):590–594.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

March 1, 1997

Volume

79

Issue

5

Start / End Page

590 / 594

Location

United States

Related Subject Headings

  • Vascular Patency
  • United States
  • Treatment Outcome
  • Risk Factors
  • Recurrence
  • Myocardial Revascularization
  • Myocardial Ischemia
  • Myocardial Infarction
  • Middle Aged
  • Medicare