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Related Experiment Videos

The ARTS study (Arterial Revascularization Therapies Study).

P W Serruys1, F Unger, B A van Hout

  • 1Department of Interventional Cardiology, Heartcenter/Eramus University Rotterdam/Interuniversity Cardiology Institute of the Netherlands. serruys@card.azr.nl

Seminars in Interventional Cardiology : SIIC
|March 30, 2000
PubMed
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This summary is machine-generated.

Coronary artery bypass grafting (CABG) surgery and stenting offer comparable event-free survival for multivessel disease. Stenting is cost-effective, particularly with lower cost estimates, compared to CABG.

Area of Science:

  • Cardiovascular medicine
  • Health economics
  • Interventional cardiology

Background:

  • Rising healthcare costs necessitate evaluating new treatments based on cost-effectiveness.
  • Percutaneous transluminal coronary angioplasty (PTCA) with stenting has emerged as a significant alternative to traditional surgical procedures.
  • Multivessel disease requires careful consideration of treatment options balancing efficacy and cost.

Purpose of the Study:

  • To compare the effectiveness and cost-effectiveness of coronary artery bypass grafting (CABG) surgery versus multiple stenting in patients with multivessel disease.
  • To analyze short-term, medium-term, and long-term clinical follow-up, including event-free survival.
  • To assess quality of life and economic impact of both treatment modalities.

Main Methods:

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  • A large-scale, multinational, multicenter trial involving 19 countries and 68 sites.
  • Randomized 1205 patients with multivessel disease, selected based on equal treatability by both techniques.
  • Clinical follow-up included event-free survival at 30 days, 1 year, 3 years, and 5 years, alongside cost-effectiveness and quality-of-life assessments (EuroQol and SF-36).

Main Results:

  • No significant difference in event-free survival or effectiveness at 1 year between CABG and stenting was hypothesized.
  • Expected costs and effects were analyzed for different stenting scenarios (2 or 3 vessels diseased, high or low cost estimates) versus CABG.
  • Stenting demonstrated cost-effectiveness in both 2- and 3-vessel disease groups under lower cost assumptions, and in the 2-vessel disease group under higher cost assumptions.

Conclusions:

  • Stenting is not anticipated to be clinically more effective than CABG for multivessel disease.
  • Stenting presents a cost-effective alternative to CABG, especially when considering lower cost estimates.
  • The findings support the evaluation of stenting as a viable and economically favorable option in specific patient populations with multivessel disease.