scholarly journals Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e053305
Author(s):  
Peter Lee ◽  
Angela L Brennan ◽  
Dion Stub ◽  
Diem T Dinh ◽  
Jeffrey Lefkovits ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Public Hospitals ◽  
Confounding Factors ◽  
Cost Burden ◽  
System Perspective ◽  
Cost Drivers ◽  
Percutaneous Coronary ◽  
Procedural Costs ◽  
Over Time

ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.

Sex-specific effects of diabetes on adverse outcomes after percutaneous coronary intervention: Trends over time

2007 ◽  
Vol 153 (6) ◽  
pp. 970-978 ◽  
Author(s):  
Kimberly P. Champney ◽  
Emir Veledar ◽  
Mitchel Klein ◽  
Habib Samady ◽  
Deborah Anderson ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Specific Effects ◽  
Percutaneous Coronary ◽  
Trends Over Time ◽  
Over Time

Temporal trends of acute kidney injury in patients undergoing percutaneous coronary intervention over a span of 12 years

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Skalsky ◽  
T Bental ◽  
H Vaknin-Assa ◽  
A Assali ◽  
G Greenberg ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Percutaneous Coronary Intervention ◽  
Serum Creatinine ◽  
Temporal Trends ◽  
Early Period ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Late Period ◽  
Percutaneous Coronary ◽  
Over Time

Abstract Background Acute kidney injury (AKI) is a known complication following percutaneous coronary intervention (PCI), and is associated with higher rates of complications. We sought to determine the potential impact of temporal changes on the rates of AKI over time, as well as possible determinants of risk. Methods From a large prospective registry of patients undergoing PCI, 20,032 consecutive patients were assessed at two time periods: 2006–2012 and 2012–2018. Of these, included were cases for which data existed regarding change in creatinine levels from baseline to 48 hours after PCI. AKI was defined according to two methods- a relative elevation of ≥25% in serum creatinine or an absolute elevation of ≥0.5 mg/dL in serum creatinine at 48 hours. Results 15,153 patients were available for final analysis, 7,913 in the first period and 7,240 in the second. Mean age was 65.0y and 66.0y (p<0.01) and baseline creatinine was 1.08 mg/dL and 1.15 mg/dL respectively (p<0.01, table 1). AKI according to 25% relative rise in serum creatinine was documented in 11.1% in the early period and in 7.3% of the patients in the late period, p<0.01. According to the definition of 0.5 mg/dL absolute rise in serum creatinine, respective rates were 3% and 2.9%, p=0.82 (figure 1). Multivariate analysis demonstrated a lower risk of AKI in the late period (OR- 0.72; CI 0.61–0.85, P<0.01). Factors associated with risk of AKI included reduced ejection fraction (OR-0.98; CI 0.976–0.99, p<0.01), older age (OR-1.01; CI 1.005–1.02, p=0.01) and female gender (OR- 1.73; CI 1.46–2.06, p<0.01). Conclusions We have witnessed an improvement in the rates of post-PCI AKI over time. Further research is warranted, to further reduce peri-procedural AKI. Figure 1. Change in the rates of AKI Funding Acknowledgement Type of funding source: None

scholarly journals Relation between door-to-balloon times and mortality after primary percutaneous coronary intervention over time: a retrospective study

The Lancet ◽  
2015 ◽  
Vol 385 (9973) ◽  
pp. 1114-1122 ◽  
Author(s):  
Brahmajee K Nallamothu ◽  
Sharon-Lise T Normand ◽  
Yongfei Wang ◽  
Timothy P Hofer ◽  
John E Brush ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Retrospective Study ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Door To Balloon ◽  
Over Time

scholarly journals Trends in clinical outcomes and survival following prehospital thrombolytic therapy given by ambulance clinicians for ST-elevation myocardial infarction in rural sub-arctic Norway

2017 ◽  
Vol 8 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Jan Mannsverk ◽  
Terje Steigen ◽  
Harald Wang ◽  
Pål Morten Tande ◽  
Birgitte Mannsverk Dahle ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Thrombolytic Therapy ◽  
Clinical Outcomes ◽  
Rural Areas ◽  
Systolic Heart Failure ◽  
Coronary Intervention ◽  
Ambulance Personnel ◽  
Percutaneous Coronary ◽  
Over Time

Background: Prehospital thrombolytic therapy given by ambulance emergency medical services to patients with acute ST-segment elevation myocardial infarction (STEMI) may produce earlier reperfusion than percutaneous coronary intervention. Clinical results from prehospital thrombolytic therapy in rural areas are scarce. Methods: We studied outcomes during 11 years of a prehospital thrombolytic therapy system in rural sub-arctic Norway. Ambulance personnel gave protocol basic treatment and transmitted electrocardiograms to hospital physicians who made the decision for prehospital thrombolytic therapy. The study was divided into three time periods; 2000–2003, 2004–2007 and 2008–2011. Results: A total of 385 STEMI patients received prehospital thrombolytic therapy, median patient age was 61.2 years, and 77% were men. Time saved by prehospital reperfusion therapy was 131 minutes. The proportion who got prehospital thrombolytic therapy within 2 hours of symptom onset increased from 21% in 2000–2003 to 39% in 2008–2011 ( P=0.003). The proportion who underwent coronary angiography or percutaneous coronary intervention within 24 hours of first medical contact increased from 56.4% to 95.4% ( P<0.001). Post-STEMI systolic heart failure decreased from 19.4% to 8.1% ( P=0.02), while 1-year mortality fell, non-significantly, by 50% over time to reach 5.6%. Thirteen patients suffered acute out-of-hospital cardiac arrest; all were successfully defibrillated. Ten patients had major bleeding events (2.6%). Conclusion: A decentralised prehospital thrombolytic therapy system based on ambulance personnel, telemetry and centralised 7/24 invasive diagnosis and treatment service, combined with system maturation over time, was associated with earlier reperfusion, improved clinical outcomes and better survival. Prehospital thrombolytic therapy is a feasible and safe intervention used in rural settings with long evacuation lines to percutaneous coronary intervention facilities.

Fame Comes at a Cost: A Canadian Analysis of Procedural Costs in Use of Pressure Wire to Guide Multivessel Percutaneous Coronary Intervention

2011 ◽  
Vol 27 (2) ◽  
pp. 262.e1-262.e2 ◽  
Author(s):  
Stephen P. Hoole ◽  
Michael D. Seddon ◽  
Rohan S. Poulter ◽  
G.B. John Mancini ◽  
David A. Wood ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Pressure Wire ◽  
Percutaneous Coronary ◽  
Procedural Costs

scholarly journals Symptoms and feelings valued by patients after a percutaneous coronary intervention: a discrete-choice experiment to inform development of a new patient-reported outcome

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e023141 ◽  
Author(s):  
Anna L Barker ◽  
Geeske Peeters ◽  
Renata T Morello ◽  
Richard Norman ◽  
Darshini Ayton ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Choice Experiment ◽  
Coronary Intervention ◽  
Patient Reported Outcome ◽  
Public Hospitals ◽  
Conditional Logit ◽  
Percutaneous Coronary ◽  
Patient Reported

ObjectiveTo inform the development of a patient-reported outcome measure, the aim of this study was to identify which symptoms and feelings following percutaneous coronary intervention (PCI) are most important to patients.DesignDiscrete-choice experiment consisting of two hypothetical scenarios of 10 symptoms and feelings (pain or discomfort; shortness of breath; concern/worry about heart problems; tiredness; confidence to do usual activities; ability to do usual activities; happiness; sleep disturbance; dizziness or light-headedness and bruising) experienced after PCI, described by three levels (never, some of the time, most of the time). Preference weights were estimated using a conditional logit model.SettingFour Australian public hospitals that contribute to the Victorian Cardiac Outcomes Registry (VCOR) and a private insurer’s claim database.Participants138 people aged >18 years who had undergone a PCI in the previous 6 months.Main outcome measuresPatient preferences via trade-offs between 10 feelings and symptoms.ResultsOf the 138 individuals recruited, 129 (93%) completed all 16 choice sets. Conditional logit parameter estimates were mostly monotonic (eg, moving to worse levels for each individual symptom and feeling made the option less attractive). When comparing the magnitude of the coefficients (based on the coefficient of the worst level relative to best level in each item), feeling unhappy was the symptom or feeling that most influenced perception of a least-preferred PCI outcome (OR 0.42, 95% CI 0.34 to 0.51, p<0.0001) and the least influential was bruising (OR 0.81, 95% CI 0.67 to 0.99, p=0.04).ConclusionThis study provides new insights into how patients value symptoms and feelings they experience following a PCI.

scholarly journals Changes over time in serum albumin levels predict outcomes following percutaneous coronary intervention

2020 ◽  
Vol 75 (4) ◽  
pp. 381-386 ◽  
Author(s):  
Arthur Shiyovich ◽  
Tamir Bental ◽  
Abid Assali ◽  
Hana Vaknin-Assa ◽  
Ran Kornowski ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Serum Albumin ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Changes Over Time ◽  
Over Time

scholarly journals Treatment Pattern of Antithrombotic Therapy over Time after Percutaneous Coronary Intervention in Patients with Atrial Fibrillation in Real-World Practice in Korea

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1185
Author(s):  
Seongwook Han ◽  
Sola Han ◽  
Sung-Won Jang ◽  
Myung-Yong Lee ◽  
Young-Keun On ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Triple Therapy ◽  
Real World ◽  
Treatment Duration ◽  
Coronary Intervention ◽  
Treatment Pattern ◽  
Antithrombotic Treatment ◽  
Percutaneous Coronary ◽  
Over Time

We examined antithrombotic treatment patterns with clinical characteristics and therapy changes over time in patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI). Using the Health Insurance Review and Assessment service claims database (01JAN2007-30NOV2016) in Korea, we included adult patients with AF and PCI: (1) who underwent PCI with stenting between 01JAN2008 and 30NOV2016; (2) with ≥1 claim for AF (ICD code: I48) (3) with antithrombotics 1 day prior to or at the date of PCI; and (4) with CHADS2-VASc of ≥2. In this study, 7749 patients with AF who underwent PCI, triple therapy, dual therapy, dual antiplatelet therapy (DAPT), and single antiplatelet therapy were prescribed to 24.6%, 3.4%, 60.8%, and 11.0%, respectively. In the triple therapy group, 23.1% persisted with triple therapy for 12 months, whereas the remaining patients switched to a different therapy. In the entire cohort and several subgroups, the median treatment duration of triple therapy was 55–87 days. DAPT use for 12 months was the most common treatment pattern (62.6%) in the DAPT group (median treatment duration, 324–345 days). A significant discrepancy exists between the current guidelines and real-world practice regarding antithrombotic treatment with PCI for patients with AF. Appropriate use of anticoagulants should be emphasized.

Sign in / Sign up

Export Citation Format

Share Document