CABG Deemed More Effective Than PCI for 2- or 3-Vessel CAD
(HealthDay News) — For patients with coronary artery disease, coronary artery bypass graft (CABG) is more effective but more costly than percutaneous coronary intervention (PCI), according to research published in the January 6 issue of the Journal of the American College of Cardiology.
Zugui Zhang, PhD, from the Value Institute at the Christiana Care Health System in Newark, DE, and colleagues examined the cost-effectiveness of CABG vs. PCI for stable ischemic heart disease using data from the Society of Thoracic Surgeons and American College of Cardiology Foundation databases linked to claims data from the Centers for Medicare and Medicaid Services. Mortality and life expectancy data were used to measure effectiveness. Data were included for 86,244 CABG patients and 103,549 PCI patients who were at least 65 years old and had two- or three-vessel coronary artery disease.
The researchers found that CABG was associated with higher adjusted costs for the index hospitalization ($10,670), study period ($8,145), and lifetime ($11,575). Relative to PCI, patients undergoing CABG gained an adjusted average of 0.2525 life-years over the observation period and 0.3801 life-years over the lifetime. For CABG vs. PCI, the life-time incremental cost-effectiveness ratio of CABG versus PCI was $30,454/quality-adjusted life-year gained.
"Over a period of four years or longer, patients undergoing CABG had better outcomes but at higher costs than those undergoing PCI," the authors write.
One author disclosed financial ties to the pharmaceutical industry.