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Updated: Aug 8, 2026

Prehospital Thrombolysis: A Manual from Berlin
05:52

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Cost and quality of life: thrombolysis and primary angioplasty

L Goldman1

  • 1Department of Medicine, University of California-San Francisco School of Medicine 94143, USA.

Journal of the American College of Cardiology
|June 1, 1995
PubMed

Insights

Primary angioplasty offers a significant mortality reduction for acute myocardial infarction patients with no added cost. This cardiac intervention shows greater benefits than thrombolytic therapies like streptokinase and tissue-type plasminogen activator (t-PA).

Area of Science:

  • Cardiology
  • Health Economics

Background:

  • Cardiac interventions require cost-effectiveness analysis due to limited healthcare resources.
  • Evaluating the economic impact of treatments for acute myocardial infarction (AMI) is crucial.

Purpose of the Study:

  • To compare the cost-effectiveness of primary angioplasty versus thrombolytic therapies for AMI.
  • To assess the impact of different cardiac interventions on mortality and healthcare costs.

Main Methods:

  • Analysis of cost-effectiveness using generally accepted methodologies.
  • Review of pooled results from three randomized trials comparing primary angioplasty with thrombolysis.

Main Results:

  • Streptokinase therapy for AMI costs $3,500-$21,000/year of life saved.
  • Tissue-type plasminogen activator (t-PA) costs $16,000-$60,000/year of life saved compared to streptokinase.
  • Primary angioplasty may reduce mortality by 63% without increasing costs, outperforming thrombolytic therapies.

Conclusions:

  • Primary angioplasty presents a highly cost-effective strategy for AMI, potentially reducing mortality significantly.
  • Further large-scale trials are needed to confirm the population-level cost and mortality benefits of primary angioplasty over intravenous thrombolysis.

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