Cost implications of intraprocedural thrombotic events during PCI

Stephanie Plent, Weihong Fan, Ajay Kirtane, Sorin J. Brener, Philippe Genereux, Roxana Mehran, Duane S. Pinto, Margaret McEntegart, David J. Cohen, Gregg W. Stone

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objectives We sought to estimate the direct costs (in-hospital and 30-day) associated with an intraprocedural thrombotic event (IPTE) among patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI). Background Patients with IPTE have higher rates of in-hospital and 30-day major adverse cardiac events than patients without IPTE. The extent to which IPTE also add to medical costs is unknown. Methods Hospital costs for patients in the ACUITY Trial were compared between patients with and without IPTE. Adjusted comparisons were performed using generalized linear models (GLMs). All costs are reported in 2012 US dollars. Results A total of 1,307 patients with both core laboratory-based angiographic assessment and detailed economic data were included in the final study population. IPTE occurred in 52 patients (4.0%). Median in-hospital costs were higher in patients with IPTE than in those without IPTE (23,719 vs. 18,419, P=0.01). Thirty-day median costs were also higher for IPTE patients (23,719 vs. 19,556, P=0.05). After adjusting for baseline differences, IPTE was associated with 19.5% (95% CI: [2.8-38.8%], P=0.02) and 18.9% (95% CI: [1.2-39.7%], P=0.04) increases in in-hospital and 30-day costs, respectively. These relative differences represent median increases of 3,592 in initial hospital costs and 3,696 in 30-day costs. Conclusions The occurrence of IPTE during the index PCI in patients with NSTEACS is associated with substantial increases in-hospital and 30-day costs. These findings suggest that strategies to prevent IPTE may be associated with important cost offsets as well as improved clinical outcomes.

Original languageEnglish (US)
Pages (from-to)30-39
Number of pages10
JournalCatheterization and Cardiovascular Interventions
Volume86
Issue number1
DOIs
StatePublished - Jul 1 2015

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Percutaneous Coronary Intervention
Costs and Cost Analysis
Hospital Costs
Acute Coronary Syndrome
Linear Models
Economics

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Plent, Stephanie ; Fan, Weihong ; Kirtane, Ajay ; Brener, Sorin J. ; Genereux, Philippe ; Mehran, Roxana ; Pinto, Duane S. ; McEntegart, Margaret ; Cohen, David J. ; Stone, Gregg W. / Cost implications of intraprocedural thrombotic events during PCI. In: Catheterization and Cardiovascular Interventions. 2015 ; Vol. 86, No. 1. pp. 30-39.
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abstract = "Objectives We sought to estimate the direct costs (in-hospital and 30-day) associated with an intraprocedural thrombotic event (IPTE) among patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI). Background Patients with IPTE have higher rates of in-hospital and 30-day major adverse cardiac events than patients without IPTE. The extent to which IPTE also add to medical costs is unknown. Methods Hospital costs for patients in the ACUITY Trial were compared between patients with and without IPTE. Adjusted comparisons were performed using generalized linear models (GLMs). All costs are reported in 2012 US dollars. Results A total of 1,307 patients with both core laboratory-based angiographic assessment and detailed economic data were included in the final study population. IPTE occurred in 52 patients (4.0{\%}). Median in-hospital costs were higher in patients with IPTE than in those without IPTE (23,719 vs. 18,419, P=0.01). Thirty-day median costs were also higher for IPTE patients (23,719 vs. 19,556, P=0.05). After adjusting for baseline differences, IPTE was associated with 19.5{\%} (95{\%} CI: [2.8-38.8{\%}], P=0.02) and 18.9{\%} (95{\%} CI: [1.2-39.7{\%}], P=0.04) increases in in-hospital and 30-day costs, respectively. These relative differences represent median increases of 3,592 in initial hospital costs and 3,696 in 30-day costs. Conclusions The occurrence of IPTE during the index PCI in patients with NSTEACS is associated with substantial increases in-hospital and 30-day costs. These findings suggest that strategies to prevent IPTE may be associated with important cost offsets as well as improved clinical outcomes.",
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Plent, S, Fan, W, Kirtane, A, Brener, SJ, Genereux, P, Mehran, R, Pinto, DS, McEntegart, M, Cohen, DJ & Stone, GW 2015, 'Cost implications of intraprocedural thrombotic events during PCI', Catheterization and Cardiovascular Interventions, vol. 86, no. 1, pp. 30-39. https://doi.org/10.1002/ccd.25909

Cost implications of intraprocedural thrombotic events during PCI. / Plent, Stephanie; Fan, Weihong; Kirtane, Ajay; Brener, Sorin J.; Genereux, Philippe; Mehran, Roxana; Pinto, Duane S.; McEntegart, Margaret; Cohen, David J.; Stone, Gregg W.

In: Catheterization and Cardiovascular Interventions, Vol. 86, No. 1, 01.07.2015, p. 30-39.

Research output: Contribution to journalArticle

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AU - Plent, Stephanie

AU - Fan, Weihong

AU - Kirtane, Ajay

AU - Brener, Sorin J.

AU - Genereux, Philippe

AU - Mehran, Roxana

AU - Pinto, Duane S.

AU - McEntegart, Margaret

AU - Cohen, David J.

AU - Stone, Gregg W.

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N2 - Objectives We sought to estimate the direct costs (in-hospital and 30-day) associated with an intraprocedural thrombotic event (IPTE) among patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI). Background Patients with IPTE have higher rates of in-hospital and 30-day major adverse cardiac events than patients without IPTE. The extent to which IPTE also add to medical costs is unknown. Methods Hospital costs for patients in the ACUITY Trial were compared between patients with and without IPTE. Adjusted comparisons were performed using generalized linear models (GLMs). All costs are reported in 2012 US dollars. Results A total of 1,307 patients with both core laboratory-based angiographic assessment and detailed economic data were included in the final study population. IPTE occurred in 52 patients (4.0%). Median in-hospital costs were higher in patients with IPTE than in those without IPTE (23,719 vs. 18,419, P=0.01). Thirty-day median costs were also higher for IPTE patients (23,719 vs. 19,556, P=0.05). After adjusting for baseline differences, IPTE was associated with 19.5% (95% CI: [2.8-38.8%], P=0.02) and 18.9% (95% CI: [1.2-39.7%], P=0.04) increases in in-hospital and 30-day costs, respectively. These relative differences represent median increases of 3,592 in initial hospital costs and 3,696 in 30-day costs. Conclusions The occurrence of IPTE during the index PCI in patients with NSTEACS is associated with substantial increases in-hospital and 30-day costs. These findings suggest that strategies to prevent IPTE may be associated with important cost offsets as well as improved clinical outcomes.

AB - Objectives We sought to estimate the direct costs (in-hospital and 30-day) associated with an intraprocedural thrombotic event (IPTE) among patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI). Background Patients with IPTE have higher rates of in-hospital and 30-day major adverse cardiac events than patients without IPTE. The extent to which IPTE also add to medical costs is unknown. Methods Hospital costs for patients in the ACUITY Trial were compared between patients with and without IPTE. Adjusted comparisons were performed using generalized linear models (GLMs). All costs are reported in 2012 US dollars. Results A total of 1,307 patients with both core laboratory-based angiographic assessment and detailed economic data were included in the final study population. IPTE occurred in 52 patients (4.0%). Median in-hospital costs were higher in patients with IPTE than in those without IPTE (23,719 vs. 18,419, P=0.01). Thirty-day median costs were also higher for IPTE patients (23,719 vs. 19,556, P=0.05). After adjusting for baseline differences, IPTE was associated with 19.5% (95% CI: [2.8-38.8%], P=0.02) and 18.9% (95% CI: [1.2-39.7%], P=0.04) increases in in-hospital and 30-day costs, respectively. These relative differences represent median increases of 3,592 in initial hospital costs and 3,696 in 30-day costs. Conclusions The occurrence of IPTE during the index PCI in patients with NSTEACS is associated with substantial increases in-hospital and 30-day costs. These findings suggest that strategies to prevent IPTE may be associated with important cost offsets as well as improved clinical outcomes.

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