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Clinical and Economic Outcomes of Coronary Angioplasty Alone or in Combination with Stents in Academic Health Centers: A Retrospective Database Analysis

  1. Michael J. Oinonen PharmD1,
  2. Kasem S. Akhras PharmD2,
  3. Connie Chen PharmD2,
  4. Karl A. Matuszewski PharmD, MS1,
  5. Peter H. Vlasses PharmD1

Article first published online: 25 DEC 2001

DOI: 10.1046/j.1524-4733.2000.34002.x

Issue

Value in Health

Value in Health

Volume 3, Issue 4, pages 253–260, July 2000

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How to Cite

Oinonen, M. J., Akhras, K. S., Chen, C., Matuszewski, K. A. and Vlasses, P. H. (2000), Clinical and Economic Outcomes of Coronary Angioplasty Alone or in Combination with Stents in Academic Health Centers: A Retrospective Database Analysis. Value in Health, 3: 253–260. doi: 10.1046/j.1524-4733.2000.34002.x

Author Information

  1. 1

    University HealthSystem Consortium, Oak Brook, IL;

  2. 2

    Pharmacia, Skokie, IL

*Address correspondence to: Michael J Oinonen, PharmD and Fellow, Clinical Practice Advancement Center, University HealthSystem Consortium, 2001 Spring Road, Suite 700, Oak Brook, IL 60523. E-mail: oinonen@uhc.edu

Publication History

  1. Issue published online: 25 DEC 2001
  2. Article first published online: 25 DEC 2001

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Keywords:

  • coronary stents;
  • outcomes research;
  • percutaneous transluminal coronary angioplasty;
  • retrospective database analysis

Objectives: Indications for the use of stents are evolving and their optimal place in therapy remains to be defined. The objective was to compare the 1-year clinical and economic outcomes of percutaneous transluminal coronary agioplasty (PTCA) with and without the use of stents.

Methods: This retrospective database analysis was conducted using data from 60 US academic medical centers in 1996 and 1997. Outcomes of interest included in-hospital mortality (both on sentinel and readmission visits), readmission rates, revascularization procedures, length of stay, and the cost of sentinel and readmission hospitalization.

Results: A total of 27,020 patients either did (n = 13,254) or did not (n = 13,766) receive coronary stents in conjunction with PTCA. The median cost of hospitalization for the stent group was about $1,409 higher (mean, $1,200) than the no-stent group and the length of stay was similar (4.3 days vs. 4.5 days, respectively, P = .2628). Mortality rates on readmission (0.9% stent vs. 0.8% no-stent, P = NS) did not differ. However, patients in the stent group had better mortality rates compared to the no-stent group during the sentinel visit (1.7% vs. 2.7%, P < .001). Stent use was not associated with a significantly lower risk of a revascularization procedure on readmission to the same institution (OR 0.95, 95% CI 0.87–1.04, P = .28).

Conclusions: Stents were associated with a 1% decrease of inpatient mortality during the sentinel visit without impacting length of stay or readmission rates. This advantage was associated with a $1,409 higher median cost of hospitalization in the stent group.

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