Clinical and economic impact of diabetes mellitus on percutaneous and surgical treatment of multivessel coronary disease patients
Circulation
; 104: 533-538, 29 de julho de 2001.
Article
in English
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1061979
Responsible library:
BR79.1
Localization: BR79.1
ABSTRACT
BackgroundOur aims were to compare coronary artery bypass grafting (CABG) and stenting for the treatment of diabetic patients with multivessel coronary disease enrolled in the Arterial Revascularization Therapy Study (ARTS) trial and to determine the costs of these 2 treatment strategies. Methods and ResultsPatients (n51205) were randomly assigned to stent implantation (n5600; diabetic, 112) or CABG (n5605; diabetic, 96). Costs per patient were calculated as the product of each patients use of resources and the corresponding unit costs. Baseline characteristics were similar between the groups. At 1 year, diabetic patients treated with stenting had the lowest event-free survival rate (63.4%) because of a higher incidence of repeat revascularization compared with both diabetic patients treated with CABG (84.4%, P,0.001) and nondiabetic patients treated with stents (76.2%, P50.04). Conversely, diabetic and nondiabetic patients experienced similar 1-year event-free survival rates when treated with CABG (84.4% and 88.4%). The total 1-year costs for stenting and CABG in diabetic patients were $12 855 and $16 585 (P,0.001) and in the nondiabetic groups, $10 164 for stenting and $13 082 for surgery. ConclusionsMultivessel diabetic patients treated with stenting had a worse 1-year outcome than patients assigned to CABG or nondiabetics treated with stenting. The strategy of stenting was less costly than CABG, however, regardless of diabetic status.
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Collection:
National databases
/
Brazil
Database:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Main subject:
Coronary Disease
/
Diabetes Mellitus
/
Myocardial Revascularization
Type of study:
Health economic evaluation
Language:
English
Journal:
Circulation
Year:
2001
Document type:
Article
Institution/Affiliation country:
Academisch Ziekenhuis Rotterdam Dijkzigt/NL
/
CHU Sart Tilman/BE
/
Cardialysis BV/NL
/
Erasmus University Rotterdam/NL
/
Herzzentrum Leipzig/DE
/
Institute for Medical Technology Assessment/NL
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Landeskliniken/AT