Clinical and economic impact of diabetes mellitus on percutaneous and surgical treatment of multivessel coronary disease patients: insights from the arterial revascularization therapy study (ARTS) trial

Abizaid, Andréa; Costa, M.A; Al, Marques

doi:10.1016/s1062-1458(01)00580-3

Cited by 94 publications

(119 citation statements)

References 15 publications

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“…22 Diabetic patients experienced higher rates of death, myocardial infarction, and repeat revascularization at 1 year (39.3% after stenting versus 17.7% after CABG; absolute difference, 21.6%; PϽ0.001), largely because of a much lower need for repeat revascularization after CABG (3.1% versus 22.3%, PϽ0.001). Diabetes was an independent predictor of adverse events at 1 year (RR, 2.07).…”

Section: Impact Of Stents On Outcomes After Revascularizationmentioning

confidence: 99%

Indications for Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention in Chronic Stable Angina

et al. 2003

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Section: Impact Of Stents On Outcomes After Revascularizationmentioning

confidence: 99%

Indications for Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention in Chronic Stable Angina

et al. 2003

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“…19 A mortality rate of 7.1% at 3 years was observed with stenting, versus 4.2% with CABG (Pϭ0.39). However, this trend in favor of surgery needs to be assessed by a longer follow-up or larger sample size.…”

Section: Influence Of Diabetesmentioning

confidence: 99%

Three-Year Outcome After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease

et al. 2004

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on behalf of the Arterial Revascularization Therapy Study (ARTS) InvestigatorsBackground-The primary results of Arterial Revascularization Therapy Study reported a greater need for repeated revascularization after percutaneous coronary intervention with stenting (PCI). However, PCI was less expensive than coronary artery bypass grafting (CABG) and offered the same degree of protection against death, stroke, and myocardial infarction. Methods and Results-Patients with multivessel disease (nϭ1205) were randomly assigned to either CABG or PCI and followed up for up to 3 years. Survival rates without stroke or myocardial infarction were similar in each group at 1 year and 3 years (90.5% versus 91.4% for PCI versus CABG at 1 year and 87.2% versus 88.4% for PCI versus CABG at 3 years). However, the respective repeat revascularization rates were 21.2% and 26.7% at 1 and 3 years in patients allocated to PCI, compared with 3.8% and 6.6% in patients allocated to CABG (PϽ0.0001). Diabetes (PϽ0.0009) and maximal pressure for stent deployment (PϽ0.002) are the strongest independent predictors of events at 3 years after PCI, whereas left anterior descending coronary artery grafting (PϽ0.006) is the best predictor of event-free survival at 3 years after CABG. The incremental cost of surgery compared with PCI for an event-free patient was 19 257 € at 1 year but decreased to 10 492 € at 3 years. It remained at 142 391 € at 3 years when revascularization procedures were excluded in the efficacy end point, however. Conclusions-Three-year survival rates without stroke and myocardial infarction are identical in both groups, and the cost/benefit ratio of stenting is determined primarily by the increasing need for revascularization in the PCI group.

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“…Interestingly, the cost differences between PTCA and CABG were similar for both diabetic and non-diabetic patients. 199 The incremental cost-effectiveness ratio of CABG over stenting was $21,000 (£13,054) for each patient who remained event free at 1 year. Long-term follow-up is planned to determine the extent of any further erosion of the cost differences over 3-5 years.…”

Section: Percutaneous Versus Surgical Revascularisation For Multivessmentioning

confidence: 99%

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

143

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Clinical and economic impact of diabetes mellitus on percutaneous and surgical treatment of multivessel coronary disease patients: insights from the arterial revascularization therapy study (ARTS) trial

Cited by 94 publications

References 15 publications

Indications for Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention in Chronic Stable Angina

Indications for Coronary Artery Bypass Surgery and Percutaneous Coronary Intervention in Chronic Stable Angina

Three-Year Outcome After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease

Coronary artery stents: a rapid systematic review and economic evaluation

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