[Comparison of long-term clinical results and cost-effectiveness of percutaneous coronary angioplasty and coronary artery bypass grafting].
Cost-effectiveness was studied in 313 cases who had PTCA and 161 cases who had CABG as a first measure of interventional therapy for their coronary heart disease. Follow-up time ranged from 2 years to 5 years and 9 months with a mean interval of 3 years and 10 months. In the PTCA group a mean of 1.33 successfully dilated vessels/patient was obtained, but a total of 100 additional PTCA or bypass surgery procedure was necessary in the follow-up period. In the CABG group a mean of 2.60 patent grafts/patient was obtained. Mean length of hospital stay and charge was 21.9 days and 2,071 thousand yen in the PTCA group, and 82.2 days and 5,122 thousand yen in the CABG group through the entire follow up period. Cardiac event-free survival rate was significantly worse in the PTCA group. In the subgroup of two vessel disease, mean number of successfully dilated targets or patent grafts was 1.32 in the PTCA group and 1.88 in the CABG group. Total length of hospital stay and charge was 24.1 days and 2,352 thousand yen in the PTCA group and 86.2 days and 4,903 thousand yen in the CABG group. Cardiac event-free survival rate was significantly worse in the PTCA group. In the subgroup of three vessel disease, PTCA yielded 1.34 dilated target vessels, whereas CABG 2.66 patent grafts, which was two times more than the former one. Total length of hospital stay and charge was 32.7 days and 2,612 thousand yen in the PTCA group, and 82.4 days and 5,225 thousand yen in the CABG group.(ABSTRACT TRUNCATED AT 250 WORDS)
Ohashi
H
H
Department of Surgery, Fukui Cardiovascular Center, Japan.
Tsutsumi
Y
Y
Murakami
A
A
Ueyama
K
K
Fukahara
K
K
Yamashita
A
A
Ohnaka
M
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000191:economics*; D001026:Coronary Artery Bypass / Q000191:economics*; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy; D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis