Comparison of the cost in percutaneous coronary intervention between ST-segment elevation myocardial infarction vs....

Area of Science:

• Cardiology
• Interventional Cardiology
• Health Economics

Background:

• Percutaneous coronary intervention (PCI) is a primary treatment for acute myocardial infarction (AMI), including both ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI).
• Previous observations suggest potential cost variations in PCI procedures between STEMI and NSTEMI, possibly due to differences in lesion complexity.

Purpose of the Study:

• To compare the total device costs associated with PCI in patients diagnosed with STEMI versus NSTEMI.
• To analyze differences in device utilization and procedural costs between these two patient groups.

Main Methods:

• A retrospective study involving 504 acute myocardial infarction (AMI) patients who underwent PCI.
• Patients were categorized into STEMI (n=286) and NSTEMI (n=218) groups.
• Comparison of total device cost, number of devices used, and procedure costs between the two groups, with multivariate logistic regression for cost association.

Main Results:

• The NSTEMI group exhibited significantly higher total device costs (¥371,300) compared to the STEMI group (¥341,200).
• Conversely, the STEMI group incurred significantly higher procedure costs (¥343,800) than the NSTEMI group (¥220,000).
• Drug-eluting stents and aspiration catheters were more common in STEMI, while rotablators were more frequent in NSTEMI. NSTEMI was independently associated with higher device costs (OR 1.899).

Conclusions:

• Total device costs for PCI are significantly greater in NSTEMI cases compared to STEMI cases.
• Procedure costs are notably higher in STEMI interventions than in NSTEMI interventions.
• These findings underscore distinct economic profiles for PCI in different types of acute myocardial infarction, influenced by lesion characteristics and device selection.