Cost-effectiveness of stepwise provisional versus systematic dual stenting strategies in patients with distal bifurcation left main stem lesions: economic analysis of the EBC MAIN trial.
Open Heart
; 11(1)2024 Jan 19.
Article
en En
| MEDLINE
| ID: mdl-38242557
ABSTRACT
BACKGROUND:
In patients with distal bifurcation left main stem lesions requiring intervention, the European Bifurcation Club Left Main Coronary Stent Study trial found a non-significant difference in major adverse cardiac events (MACEs, composite of all-cause death, non-fatal myocardial infarction and target lesion revascularisation) favouring the stepwise provisional strategy, compared with the systematic dual stenting.AIMS:
To estimate the 1-year cost-effectiveness of stepwise provisional versus systematic dual stenting strategies.METHODS:
Costs in France and the UK, and MACE were calculated in both groups to estimate the incremental cost-effectiveness ratio (ICER). Uncertainty was explored by probabilistic bootstrapping. The analysis was conducted from the perspective of the healthcare provider with a time horizon of 1 year.RESULTS:
The cost difference between the two groups was -755 (5700 in the stepwise provisional group and 6455 in the systematic dual stenting group, p value<0.01) in France and -647 (6728 and 7375, respectively, p value=0.08) in the UK. The point estimates for the ICERs found that stepwise provisional strategy was cost saving and improved outcomes with a probabilistic sensitivity analysis confirming dominance with an 80% probability.CONCLUSION:
The stepwise provisional strategy at 1 year is dominant compared with the systematic dual stenting strategy on both economic and clinical outcomes.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
/
Intervención Coronaria Percutánea
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Health_economic_evaluation
Límite:
Humans
Idioma:
En
Revista:
Open Heart
/
Open heart (Online)
Año:
2024
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Reino Unido