Cost-utility analysis of early thrombolytic therapy
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Updated: Oct 23, 2026
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Published on: November 26, 2013
D Castiel1, C Hervé, M Gaillard
1Institute Universaire de Technologie, France.
Insights
Promptly initiating thrombolytic treatment for acute myocardial infarction (AMI) offers similar cost-utility to delayed treatment. However, preventing AMI altogether is the most effective strategy for preserving patient quality of life.
Area of Science:
- Cardiology
- Health Economics
Background:
- Acute myocardial infarction (AMI) significantly impacts patient quality of life.
- Thrombolytic therapy is a critical intervention for AMI.
Purpose of the Study:
- To evaluate the cost-utility of thrombolytic treatment for AMI.
- To determine the influence of treatment timing and infarct location on cost-effectiveness.
Main Methods:
- Cost-utility analysis was conducted on 167 patients with AMI.
- Data were collected from 12 cardiology centers.
- Cost-utility ratios were calculated based on thrombolysis initiation time and infarct location.
Main Results:
- Early (<3 hours) and late (>3 hours) thrombolysis showed comparable cost-utility ratios per QALY.
- Posterior infarcts had slightly higher cost-utility ratios than anterior infarcts.
- Patients experienced an approximate 40% reduction in quality of life post-AMI.
Conclusions:
- Treatment timing and infarct location are less significant factors in resource consumption and patient well-being than the occurrence of AMI itself.
- Preventing AMI is the optimal strategy for maximizing patient quality of life.
Abstract:
167 patients suffering from acute myocardial infarction (AMI) were recruited from 12 cardiology centres and given thrombolytic treatment. Cost-utility analyses were performed and a cost-utility ratio was computed according to time of initiation of thrombolysis after the AMI and the location of the infarct. Early thrombolysis ( less than 3 hours) proved to cost about the same per QALY ($US3734 vs $US3577) as late thrombolysis ( greater than 3 hours), although posterior infarcts cost slightly more per QALY ($3433 vs $2996) than anterior infarcts. Quality of life coefficients for all patients after the AMI were judged to be about 40% less than before the AMI. Thus, in terms of resources consumed and patient well-being, time of treatment initiation or location of the infarct were less significant than the fact of having an AMI. In terms of quality of life, the best strategy is that which seeks to prevent AMI occurring.
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