Cost-utility analysis of early thrombolytic therapy.
167 patients suffering from acute myocardial infarction (AMI) were recruited from 12 cardiology centres and given thrombolytic treatment. Cost-utility analyses were performed and a cost-utility ratio was computed according to time of initiation of thrombolysis after the AMI and the location of the infarct.  Early thrombolysis ( less than 3 hours) proved to cost about the same per QALY ($US3734 vs $US3577) as late thrombolysis ( greater than 3 hours), although posterior infarcts cost slightly more per QALY ($3433 vs $2996) than anterior infarcts.  Quality of life coefficients for all patients after the AMI were judged to be about 40% less than before the AMI.  Thus, in terms of resources consumed and patient well-being, time of treatment initiation or location of the infarct were less significant than the fact of having an AMI.  In terms of quality of life, the best strategy is that which seeks to prevent AMI occurring.
Institute Universaire de Technologie, France.
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Castiel
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Hervé
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Gaillard
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Bollaert
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Soula
D016255:Anistreplase / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015912:Thrombolytic Therapy / Q000191:economics*; D026712:Value of Life