Economic outcomes of treatment strategies for type 2 diabetes mellitus and coronary artery disease in the Bypass Angioplasty Revascularization Investigation 2 Diabetes trial.

Circulation
Mark A HlatkyBypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Study Group

Abstract

The economic outcomes of clinical management strategies are important in assessing their value to patients. Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) randomized patients with type 2 diabetes mellitus and angiographically documented, stable coronary disease to strategies of (1) prompt revascularization versus medical therapy with delayed revascularization as needed to relieve symptoms and (2) insulin sensitization versus insulin provision. Before randomization, the physician declared whether coronary artery bypass grafting or percutaneous coronary intervention would be used if the patient were assigned to revascularization. We followed 2005 patients for medical utilization and costs and assessed the cost-effectiveness of these management strategies. Medical costs were higher for revascularization than medical therapy, with a significant interaction with the intended method of revascularization (P<0.0001). In the coronary artery bypass grafting stratum, 4-year costs were $80 900 for revascularization versus $60 600 for medical therapy (P<0.0001). In the percutaneous coronary intervention stratum, costs were $73 400 for revascularization versus $67 800 for medical therapy (P<0.02). Costs also were hig...Continue Reading

Associated Clinical Trials

Sep 29, 2000·Maria Mori Brooks, Maria Mori Brooks

References

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Citations

Sep 17, 2010·Current Atherosclerosis Reports·Stanley F Fernandez, William E Boden
Sep 1, 2011·Nature Reviews. Cardiology·Bernard R Chaitman, Abhay A Laddu
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