Related Experiment Video
Updated: Apr 23, 2026
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Resource Use Following Revascularization for Multivessel Coronary Artery Disease
Ryaan El-Andari1, Jimmy Kang1, Nicholas Fialka1
1Division of Cardiac Surgery, Department of Surgery University of Alberta Edmonton AB Canada.
Insights
Coronary artery bypass grafting (CABG) is more cost-effective and leads to fewer adverse events than percutaneous coronary intervention (PCI) for severe coronary artery disease. CABG reduces hospital readmissions and repeat procedures, improving patient outcomes and lowering healthcare costs.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Interventional Cardiology
Background:
- Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are primary revascularization methods for severe coronary artery disease.
- Previous cost-effectiveness analyses of CABG versus PCI in multivessel disease have yielded conflicting results due to limitations in sample size, follow-up duration, and contemporary data.
Purpose of the Study:
- To compare the cost-effectiveness and resource utilization of CABG and PCI in patients with severe coronary artery disease.
- To evaluate long-term outcomes, including adverse events and healthcare costs, associated with CABG and PCI.
Main Methods:
- A retrospective analysis of resource use following elective, urgent, or emergent PCI or CABG between January 1, 2009, and December 31, 2018.
- Utilized a provincial database for data collection and Canadian Institute of Health Information data for cost calculations, adjusted for inflation.
- Assessed costs for readmission and repeat revascularization, with secondary outcomes including death, myocardial infarction, rehospitalization, and repeat revascularization rates.
Main Results:
- Of 7,359 patients included, those undergoing PCI incurred significantly higher overall costs ($19,165 per person) compared to CABG ($12,612 per person).
- Patients treated with PCI exhibited higher rates of death, myocardial infarction, rehospitalization, and repeat revascularization (P<0.001).
Conclusions:
- Coronary artery bypass grafting (CABG) is associated with fewer adverse events and lower healthcare resource utilization post-discharge compared to percutaneous coronary intervention (PCI) for multivessel coronary artery disease.
- Optimizing the selection between CABG and PCI can potentially decrease readmissions and healthcare expenditures following revascularization procedures.
Background:
Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are the 2 revascularization modalities for patients with severe coronary artery disease. While CABG has often demonstrated benefits over PCI in multivessel coronary artery disease, analyses of cost effectiveness have previously shown conflicting results and are limited by sample size, follow-up time, and lack of contemporary data.
Methods:
We performed an analysis of resource use following elective, urgent, or emergent PCI or CABG from January 1, 2009, to December 31, 2018, with up to 14 years of follow-up. A provincial database was used to collect the associated data. The average cost for each event was calculated from Canadian Institute of Health Information data and was adjusted for inflation on the basis of the Bank of Canada consumer price index. Cost for each group was calculated for readmission to the hospital and repeat revascularization. Secondary outcomes included rates of death, myocardial infarction, rehospitalization, and repeat revascularization.
Results:
Of 23 243 patients who underwent angiography, 7359 were included in this study. Overall costs and costs per patient were significantly higher following PCI compared with CABG. Patients who underwent PCI required $19 165 per person in inflation-adjusted health care resource costs compared with $12 612 for CABG. Furthermore, patients who underwent PCI had higher rates of death, myocardial infarction, rehospitalization, and repeat revascularization (P<0.001).
Conclusions:
Patients with multivessel coronary artery disease experience fewer adverse events and use fewer health care resources after discharge following CABG compared with PCI. Appropriate selection of CABG versus PCI may help reduce readmissions and health care costs following revascularization.
More Related Videos
Related Concept Videos
01:27Coronary Artery Disease V: Interprofessional Care
01:27Peripheral Artery Disease III: Interprofessional Care
01:25Aortic Regurgitation III: Medical Management