Cost-effectiveness of early versus selectively invasive strategy in patients with acute coronary syndromes without ST-segment elevation

International Journal of Cardiology
L M DijksmanInvasive versus Conservative Treatment in Unstable Coronary Syndromes Investigators

Abstract

The ICTUS trial compared an early invasive versus a selectively invasive strategy in high risk patients with a non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T. Alongside the ICTUS trial a cost-effectiveness analysis from a provider perspective was performed. A total of 1200 patients with a non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T were randomized. An early invasive strategy was not superior to a selectively strategy. Total costs per patient were 1379 euros (95% CI 416-2356) more expensive in the early invasive group (13,364 euros) than in the selectively invasive group (11,985 euros). Costs of revascularization were the main determinant of the cost difference between the two groups. The incremental cost-effectiveness ratio of the extra costs per prevented cardiac event was minus 89,477 euros. The overall results of the ICTUS study showed that an early invasive strategy was not superior to a selectively invasive strategy for patients with non-ST-segment elevation acute coronary syndrome and an elevated cardiac troponin T. This economic analysis of the ICTUS study showed that an early invasive strategy was slightly more expensive during the first year w...Continue Reading

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Citations

Sep 24, 2009·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Heiko FriedelDana T Trautvetter
Oct 10, 2009·Journal of the American College of Cardiology·Robert P Giugliano, Eugene Braunwald
Sep 1, 2014·Clinical Biochemistry·Steve Goodacre, Praveen Thokala

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