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首页> 外文期刊>Journal of the American College of Cardiology >Primary angioplasty is cost-minimizing compared with pre-hospital thrombolysis for patients within 60 min of a percutaneous coronary intervention center: the Comparison of Angioplasty and Pre-hospital Thrombolysis in Acute Myocardial Infarction (CAPT
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Primary angioplasty is cost-minimizing compared with pre-hospital thrombolysis for patients within 60 min of a percutaneous coronary intervention center: the Comparison of Angioplasty and Pre-hospital Thrombolysis in Acute Myocardial Infarction (CAPT

机译：对于经皮冠状动脉介入治疗中心60分钟之内的患者，与院前溶栓治疗相比，原发性血管成形术的成本最低：急性心肌梗死（CAPT）的血管成形术和院前溶栓治疗的比较

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OBJECTIVES: This ancillary study of the Comparison of Angioplasty and Pre-hospital Thrombolysis in Acute Myocardial Infarction (CAPTIM) trial sought to assess the cost-efficacy ratio of primary coronary angioplasty (PCA) and pre-hospital thrombolysis (PHT) in patients suffering from an acute myocardial infarction (AMI) (<6 h) close to (<60 min journey) a percutaneous coronary intervention (PCI) center. BACKGROUND: In the CAPTIM study, at 30 days follow-up PCA was as equally effective as PHT with rescue angioplasty if needed. The cost efficacy of these two strategies has not yet been compared. METHODS: Data were prospectively collected for 299 patients in three centers. The efficacy analysis was extended at one-year follow-up for those patients. Direct fixed and variable actual costs were assessed with a piggyback data collection. RESULTS: The one-year primary end point event-rate (death, non-fatal myocardial infarction, and stroke) was not different after PCA or PHT (14% vs. 16. 4%, p = NS). Costs werelower in the PCA group either during the in-hospital period (8,287 vs. 9,170 Dollars , p = 0.0001) and after one-year follow-up, in relation to a higher rate of subsequent revascularizations in the PHT group (49% vs. 23%, p < 0. 01), leading to a longer hospital stay (10 vs. 9.1 days, p = 0. 03). CONCLUSIONS: After AMI in patients less than 1 h from a PCI center, PCA is as effective and less costly than a combined strategy of PHT followed by rescue angioplasty.
机译：目的：这项辅助研究比较了急性心肌梗死（CAPTIM）试验中血管成形术和院前溶栓的比较，旨在评估患有冠心病的原发性冠状动脉成形术（PCA）和院前溶栓（PHT）的成本效益比。急性心肌梗死（AMI）（<6小时）接近（<60分钟路程）经皮冠状动脉介入治疗（PCI）中心。背景：在CAPTIM研究中，如果需要，在30天的随访中，PCA与进行抢救性血管成形术的PHT一样有效。这两种策略的成本效益尚未进行比较。方法：前瞻性收集了三个中心的299例患者的数据。对这些患者在一年的随访中进行了疗效分析。直接的固定和可变的实际成本通过a带数据收集进行评估。结果：PCA或PHT治疗后的一年主要终点事件发生率（死亡，非致命性心肌梗塞和中风）无差异（14％vs.16。4％，p = NS）。在住院期间，PCA组的成本较低（8,287 vs. 9,170美元，p = 0.0001），且在一年的随访后，PHT组的后续血运重建率较高（49％vs. 23％，p <0. 01），导致住院时间更长（10天对9.1天，p = 0. 03）。结论：距离PCI中心不到1小时的患者发生AMI后，与PHT联合抢救性血管成形术的联合策略相比，PCA既有效又成本更低。

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