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• W2039789022 abstract "The role of stenting for acute myocardial infarction (AMI) has been investigated in randomised trials.1Steinhubl SR Topol EJ Stenting for acute myocardial infarction.Lancet. 1997; 350: 532-533Summary Full Text Full Text PDF PubMed Scopus (18) Google Scholar Preliminary results seem promising, and stenting may overcome some of the limitations of primary angioplasty therapy for AMI.2Weaver WD Simes RJ Betriu A et al.for the Primary Coronary Angioplasty versus Thrombolysis Collaboration GroupComparison of primary coronary angioplasty and intravenous thrombolytic therapy for acute myocardial infarction: a quantitative overview.JAMA. 1997; 278: 2093-2098Crossref PubMed Google Scholar We have recently completed the initial phase of a randomised trial of stenting versus balloon angioplasty for AMI.3H Suryapranata AWJ van't Hof JCA Hoorntje MJ De Boer Zijlstra F. A randomized comparison of primary stenting with primary balloon angioplasty in acute myocardial infarction. Circulation (in press).Google Scholar On theoretical grounds, stenting may be costeffective in various settings,4Lieu TA Gurley RJ Lundstrom RJ et al.Projected cost-effectiveness of primary angioplasty for acute myocardial infarction.J Am Coll Cardiol. 1997; 30: 1741-1750Summary Full Text Full Text PDF PubMed Scopus (60) Google Scholar but so far there are no published data on the actual costs and costeffectiveness of stenting for AMI.We have completed 12 months of follow-up in our randomised trial, including initial in-hospital and follow-up costs. We calculated costs by counting the numbers of hospital days and procedures, as previously described.5Zijlstra F de Boer MJ Beukema WP et al.Mortality, reinfarction, left ventricular ejection fraction and costs following reperfusion therapies for cute myocardial infarction.Eur Heart J. 1996; 17: 382-387Crossref PubMed Scopus (43) Google Scholar Results are shown in the table. Our data show that, at least in the setting of a Dutch (non-academic) hospital with an existing infrastructure for angioplasty and stenting, there is no difference in costs after 1 year between balloon angioplasty and stenting for AMI. Although the initial in-hospital costs of stenting are higher, this is compensated by the lower costs during follow-up, which makes stenting a good investment.TableCosts per patient (Dfl) of coronary stenting versus balloon angioplasty for acute myocardial infarctionBalloon (n=115)Stent (n=112)In-hospital costsHospital stay50005400Angioplasties90009000Stents3652304Additional balloons104161IABP196349Re-PTCA500103CABG157161Total costs1532217508Follow-up at 1 yearRe-MI44345Second angioplasty17392033Re-PTCA1607412CABG29961420Total costs67853910Total costs at 1 year2210721418re-MI=recurrent myocardial infarction; IABP=intra-aortic balloon pumping; PTCA=percutaneous coronary angioplasty; CABG=coronary bypass surgery.All costs are per patient. Open table in a new tab The role of stenting for acute myocardial infarction (AMI) has been investigated in randomised trials.1Steinhubl SR Topol EJ Stenting for acute myocardial infarction.Lancet. 1997; 350: 532-533Summary Full Text Full Text PDF PubMed Scopus (18) Google Scholar Preliminary results seem promising, and stenting may overcome some of the limitations of primary angioplasty therapy for AMI.2Weaver WD Simes RJ Betriu A et al.for the Primary Coronary Angioplasty versus Thrombolysis Collaboration GroupComparison of primary coronary angioplasty and intravenous thrombolytic therapy for acute myocardial infarction: a quantitative overview.JAMA. 1997; 278: 2093-2098Crossref PubMed Google Scholar We have recently completed the initial phase of a randomised trial of stenting versus balloon angioplasty for AMI.3H Suryapranata AWJ van't Hof JCA Hoorntje MJ De Boer Zijlstra F. A randomized comparison of primary stenting with primary balloon angioplasty in acute myocardial infarction. Circulation (in press).Google Scholar On theoretical grounds, stenting may be costeffective in various settings,4Lieu TA Gurley RJ Lundstrom RJ et al.Projected cost-effectiveness of primary angioplasty for acute myocardial infarction.J Am Coll Cardiol. 1997; 30: 1741-1750Summary Full Text Full Text PDF PubMed Scopus (60) Google Scholar but so far there are no published data on the actual costs and costeffectiveness of stenting for AMI. We have completed 12 months of follow-up in our randomised trial, including initial in-hospital and follow-up costs. We calculated costs by counting the numbers of hospital days and procedures, as previously described.5Zijlstra F de Boer MJ Beukema WP et al.Mortality, reinfarction, left ventricular ejection fraction and costs following reperfusion therapies for cute myocardial infarction.Eur Heart J. 1996; 17: 382-387Crossref PubMed Scopus (43) Google Scholar Results are shown in the table. Our data show that, at least in the setting of a Dutch (non-academic) hospital with an existing infrastructure for angioplasty and stenting, there is no difference in costs after 1 year between balloon angioplasty and stenting for AMI. Although the initial in-hospital costs of stenting are higher, this is compensated by the lower costs during follow-up, which makes stenting a good investment. re-MI=recurrent myocardial infarction; IABP=intra-aortic balloon pumping; PTCA=percutaneous coronary angioplasty; CABG=coronary bypass surgery. All costs are per patient." @default.
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• W2039789022 title "Costs of stenting for acute myocardial infarction" @default.
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