Cost-utility analysis of thrombolytic therapy

Related Experiment Video

Updated: Jun 23, 2026

Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 27, 2013

M L Simoons1, J Vos, L L Martens

  • 1Thoraxcenter, Erasmus University, Rotterdam, The Netherlands.

European Heart Journal
|June 1, 1991
PubMed

Insights

Thrombolytic therapy significantly reduces mortality and increases life years gained in heart attack patients. This cost-effective treatment offers favorable outcomes compared to conventional methods, making it a valuable cardiovascular therapy.

Area of Science:

  • Cardiology
  • Health Economics

Background:

  • Thrombolytic therapy is a crucial treatment for acute myocardial infarction.
  • Assessing the long-term cost-effectiveness of thrombolysis is essential for clinical and economic decision-making.

Purpose of the Study:

  • To analyze the 3- to 5-year cost-effectiveness of intracoronary streptokinase compared to conventional therapy.
  • To evaluate the impact of thrombolytic therapy on mortality, life years gained, and healthcare costs.

Main Methods:

  • A randomized analysis of 533 patients comparing conventional therapy with intracoronary streptokinase.
  • Follow-up data collected over 3 to 5 years, including mortality, costs, and quality of life adjustments.
  • Economic evaluation using discounted future costs and quality-adjusted life years.

Main Results:

  • Thrombolytic therapy reduced 3-year mortality from 22% to 14%.
  • Average gain in life years was 3.4 years, with higher gains for anterior (5.1 years) versus inferior (1.6 years) wall infarction.
  • Additional lifetime costs per life year gained were favorable (ECU 2940 overall), comparing well with other cardiovascular therapies.

Conclusions:

  • Intracoronary streptokinase is a highly cost-effective intervention for myocardial infarction.
  • The economic benefits justify wider application, irrespective of economic constraints.
  • Thrombolytic therapy does not significantly increase the need for subsequent procedures like bypass surgery or PTCA.

More Related Videos

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug07:50

An In vitro System to Gauge the Thrombolytic Efficacy of Histotripsy and a Lytic Drug

Published on: June 4, 2021

Related Concept Videos

Anticoagulant Drugs: Low-Molecular-Weight Heparins01:30

Anticoagulant Drugs: Low-Molecular-Weight Heparins

Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors01:20

Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors

Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...