Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction: Cost-Effectiveness Analysis of the
Carlos Chivardi1, Holly Morgan2, Mark J Sculpher1
1Centre for Health Economics, University of York, United Kingdom (C.C., M.J.S., P.S.).
Circulation. Cardiovascular Quality and Outcomes
|November 6, 2023
Summary
Percutaneous coronary intervention (PCI) did not prove cost-effective for ischemic left ventricular dysfunction, despite initial quality of life improvements. The study found PCI offered similar health benefits but at a significantly higher cost than optimal medical therapy alone.
Area of Science:
- Cardiology
- Health Economics
Background:
- Percutaneous coronary intervention (PCI) is common for ischemic left ventricular systolic dysfunction.
- The REVIVED-BCIS2 trial showed PCI did not reduce mortality or heart failure hospitalizations.
- However, PCI improved initial quality of life compared to optimal medical therapy (OMT) alone.
Purpose of the Study:
- To assess the cost-effectiveness of PCI plus OMT versus OMT alone in patients with ischemic left ventricular systolic dysfunction.
Main Methods:
- A prospective, multicenter UK trial randomized 700 patients to PCI+OMT or OMT alone.
- Health care resource use and quality-adjusted life-years (QALYs) were tracked up to 8 years.
- Costs were analyzed from a UK health system perspective.
Main Results:
- PCI+OMT resulted in similar QALYs (4.14) but higher costs (£22,352) compared to OMT alone (4.16 QALYs, £15,569).
- The incremental cost-effectiveness ratio favored OMT alone.
- The probability of PCI being cost-effective was negligible.
Conclusions:
- PCI+OMT is not cost-effective compared to OMT alone for ischemic left ventricular systolic dysfunction.
- Routine PCI for this condition is not a justifiable use of UK healthcare resources.
Keywords:
coronary artery diseaseheart failurehumansmyocardial revascularizationpercutaneous coronary interventionMore Related Videos
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