Hospitalization costs of primary stenting versus thrombolysis in acute myocardial infarction: cost analysis of the...

Area of Science:

• Cardiology
• Health Economics
• Interventional Cardiology

Background:

• Previous research demonstrated primary stenting's superior efficacy over accelerated tissue plasminogen activator (tPA) in reducing adverse cardiovascular events at six months.
• This study specifically investigates the economic implications, focusing on hospitalization costs associated with both primary stenting and accelerated tPA.

Purpose of the Study:

• To compare the hospitalization costs of primary stenting versus accelerated tPA in patients with acute myocardial infarction.
• To evaluate resource utilization and associated financial expenditures for both treatment strategies.

Main Methods:

• The Stenting versus Thrombolysis in Acute myocardial infarction Trial (STAT) randomly assigned patients to either primary stenting (n=62) or accelerated tPA (n=61).
• Detailed cost and resource usage data were collected for each patient, including physician fees obtained from the Ontario Health Insurance Plan.
• Hospitalization costs and length of stay were computed for initial hospitalization and at the six-month follow-up.

Main Results:

• Patients undergoing primary stenting had significantly shorter initial hospitalizations (6.7 days vs. 8.7 days, P<0.001) and total hospitalization days at six months (8.3 days vs. 12.1 days, P=0.001).
• Initial hospitalization costs were lower in the primary stenting group ($6354 vs. $7893, P=0.001).
• At six months, total hospitalization costs remained significantly lower for primary stenting ($7100 vs. $9559, P=0.001).

Conclusions:

• Primary stenting is a less costly treatment option compared to accelerated thrombolysis for acute myocardial infarction.
• In healthcare settings with available facilities and experienced interventionists, primary stenting presents a more cost-effective and effective strategy.