Economic evaluation of fractional flow reserve-guided versus angiography-guided multivessel revascularisation in ST-segment elevation myocardial infarction patients in the FLOWER-MI randomised trial.
EuroIntervention
; 18(3): 235-241, 2022 Jun 24.
Article
en En
| MEDLINE
| ID: mdl-35191838
ABSTRACT
BACKGROUND:
In patients with ST-segment elevation myocardial infarction (STEMI) who have multivessel disease, the FLOWER-MI trial found no significant clinical benefit to fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared to angiography-guided PCI.AIMS:
Our aim was to estimate the cost-effectiveness and cost-utility of FFR-guided PCI, the secondary endpoint of the FLOWER-MI trial.METHODS:
Costs, major adverse cardiovascular events (composite of all-cause death, non-fatal myocardial infarction [MI], and unplanned hospitalisation leading to urgent revascularisation), and quality-adjusted life years were calculated in both groups. The incremental cost-effectiveness and cost-utility ratios were estimated. Uncertainty was explored by probabilistic bootstrapping. The analysis was conducted from the perspective of the health care provider with a time horizon of one year.RESULTS:
At one year, the average cost per patient was 7,560 (±2,218) in the FFR-guided group and 7,089 (±1,991) in the angiography-guided group (p-value<0.01). The point estimates for the incremental cost-effectiveness and cost-utility ratios found that the angiography-guided strategy was cost saving and improved outcomes, with a probabilistic sensitivity analysis confirming dominance.CONCLUSIONS:
The FFR-guided strategy at one year is unlikely to be cost effective compared to the angiography-guided strategy on both clinical and quality of life outcomes.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
/
Reserva del Flujo Fraccional Miocárdico
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Intervención Coronaria Percutánea
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Infarto del Miocardio con Elevación del ST
/
Infarto del Miocardio
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Límite:
Humans
Idioma:
En
Año:
2022
Tipo del documento:
Article