Cost-effectiveness of Radial Access Percutaneous Coronary Intervention in Acute Coronary Syndrome

Area of Science:

• Cardiovascular Medicine
• Health Economics
• Interventional Cardiology

Background:

• Radial access percutaneous coronary intervention (PCI) demonstrates superior patient outcomes compared to femoral artery access.
• Limited cost-effectiveness data exists for radial access PCI, particularly in the context of acute coronary syndrome (ACS).

Purpose of the Study:

• To evaluate the cost-effectiveness of transradial versus transfemoral access PCI in patients with ACS.
• To compare patient outcomes and healthcare costs associated with both access methods over a 2-year period.

Main Methods:

• Utilized data from the Minimizing Adverse Hemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (MATRIX) trial.
• Constructed a decision analytic Markov model from an Australian healthcare perspective with a 2-year time horizon.
• Simulated recurrent cardiovascular disease and death post-PCI in a hypothetical cohort of 1000 ACS patients.

Main Results:

• Transradial access PCI was predicted to yield 12 discounted quality-adjusted life years (QALYs) more than femoral access PCI.
• Significant cost savings of AUD $51,305 (discounted) were associated with radial access PCI.
• Radial access PCI demonstrated dominance over femoral access PCI in health economic terms.

Conclusions:

• Radial access PCI is associated with improved outcomes and reduced costs compared to femoral access PCI over 2 years post-procedure.
• Findings support transradial access as the preferred approach for PCI in patients with ACS.
• The study highlights the economic and clinical benefits of radial access in interventional cardiology.