Percutaneous coronary intervention with second-generation drug-eluting stent versus bare-metal stent: Systematic review and cost-benefit analysis

PloS One
Thomas G PoderKouamé Koffi

Abstract

Drug-eluting stents (DESs) were considered as ground-breaking technology promising to eradicate restenosis and the necessity to perform multiple revascularization procedures subsequent to percutaneous coronary intervention. Soon after DESs were released on the market, however, there were reports of a potential increase in mortality and of early or late thrombosis. In addition, DESs are far more expensive than bare-metal stents (BMSs), which has led to their limited use in many countries. The technology has improved over the last few years with the second generation of DESs (DES-2). Moreover, costs have come down and an improved safety profile with decreased thrombosis has been reported. Perform a cost-benefit analysis of DES-2s versus BMSs in the context of a publicly funded university hospital in Quebec, Canada. A systematic review of meta-analyses was conducted between 2012 and 2016 to extract data on clinical effectiveness. The clinical outcome of interest for the cost-benefit analysis was target-vessel revascularization (TVR). Cost units are those used in the Quebec health-care system. The cost-benefit analysis was based on a 2-year perspective. Deterministic and stochastic models (discrete-event simulation) were used, and ...Continue Reading

Citations

Dec 1, 2017·PloS One·Rodney J Dilley, Oliver G Ash
Oct 24, 2017·Drug Delivery and Translational Research·Gil AizikGershon Golomb
Sep 18, 2018·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Alexandre AbizaidSripal Bangalore
Oct 3, 2018·Nature Biotechnology·Nicolas FioriniZhiyong Lu
Mar 11, 2020·Cardiovascular Intervention and Therapeutics·Maria Dalen TaraldsenErik Madssen
Nov 13, 2020·Biomaterials Science·Adrien HertaultNicolas Blanchemain

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