The cost:benefit ratio of acute intervention for myocardial infarction: results of a prospective, matched pair analysis

American Heart Journal
A T ChapekisE J Topol

Abstract

Parallel to the increased acceptance of intervention for acute myocardial infarction, there has been a decrease in financial resources and reimbursement. To ascertain the relative cost to benefit of intervention, we evaluated 78 matched pairs of acute myocardial infarction patients from a prospective data base of 507 consecutive patients presenting with infarction from May 1986 to July 1987. The pairs were matched for age (mean 61 years), sex (68% male), and infarct location (43% anterior). Intervention (thrombolytics and/or percutaneous transluminal coronary angioplasty [PTCA]) was only applied to patients at less than 6 hours from symptom onset. Nonintervention patients were subsequently considered for angiography and revascularization (PTCA, coronary artery bypass grafting [CABG]) based on clinical criteria. Clinical outcome was evaluated by in-hospital mortality and uncomplicated status (free of angina, heart failure, or arrhythmias) at 72 hours. Intervention was associated with decreased mortality (5.3% versus 13%, p = 0.16) and increased uncomplicated course (43% versus 19%, p less than 0.001) as compared with patients not receiving intervention. Hospital procedures for the intervention and nonintervention group were as f...Continue Reading

References

Mar 31, 1977·The New England Journal of Medicine·W B Stason, M C Weinstein
Dec 15, 1988·Annals of Internal Medicine·E J Topol
Dec 1, 1988·Journal of the American College of Cardiology·E P SteinbergA D Guerci
Feb 1, 1980·Annals of Internal Medicine·S D RobertsT L Gross

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Citations

Mar 1, 1995·Progress in Cardiovascular Diseases·J KupersmithJ Gardiner

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