PMID- 25726942 OWN - NLM STAT- MEDLINE DCOM- 20160322 LR - 20161125 IS - 1522-726X (Electronic) IS - 1522-1946 (Linking) VI - 86 IP - 1 DP - 2015 Jul TI - Cost implications of intraprocedural thrombotic events during PCI. PG - 30-9 LID - 10.1002/ccd.25909 [doi] AB - OBJECTIVES: We sought to estimate the direct costs (in-hospital and 30-day) associated with an intraprocedural thrombotic event (IPTE) among patients with non-ST-segment elevation acute coronary syndromes (NSTEACS) undergoing percutaneous coronary intervention (PCI). BACKGROUND: Patients with IPTE have higher rates of in-hospital and 30-day major adverse cardiac events than patients without IPTE. The extent to which IPTE also add to medical costs is unknown. METHODS: Hospital costs for patients in the ACUITY Trial were compared between patients with and without IPTE. Adjusted comparisons were performed using generalized linear models (GLMs). All costs are reported in 2012 US dollars. RESULTS: A total of 1,307 patients with both core laboratory-based angiographic assessment and detailed economic data were included in the final study population. IPTE occurred in 52 patients (4.0%). Median in-hospital costs were higher in patients with IPTE than in those without IPTE ($23,719 vs. $18,419, P = 0.01). Thirty-day median costs were also higher for IPTE patients ($23,719 vs. $19,556, P = 0.05). After adjusting for baseline differences, IPTE was associated with 19.5% (95% CI: [2.8-38.8%], P = 0.02) and 18.9% (95% CI: [1.2-39.7%], P = 0.04) increases in in-hospital and 30-day costs, respectively. These relative differences represent median increases of $3,592 in initial hospital costs and $3,696 in 30-day costs. CONCLUSIONS: The occurrence of IPTE during the index PCI in patients with NSTEACS is associated with substantial increases in-hospital and 30-day costs. These findings suggest that strategies to prevent IPTE may be associated with important cost offsets as well as improved clinical outcomes. CI - (c) 2015 Wiley Periodicals, Inc. FAU - Plent, Stephanie AU - Plent S AD - The Medicines Company, Parsippany, New Jersey. FAU - Fan, Weihong AU - Fan W AD - The Medicines Company, Parsippany, New Jersey. FAU - Kirtane, Ajay AU - Kirtane A AD - Columbia University Medical Center, New York Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York. FAU - Brener, Sorin J AU - Brener SJ AD - New York Methodist Hospital, Brooklyn, NY and the Cardiovascular Research Foundation, New York, New York. FAU - Genereux, Philippe AU - Genereux P AD - Columbia University Medical Center, New York Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York. FAU - Mehran, Roxana AU - Mehran R AD - Mt Sinai Medical Center and the Cardiovascular Research Foundation, New York, New York. FAU - Pinto, Duane S AU - Pinto DS AD - Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts. FAU - McEntegart, Margaret AU - McEntegart M AD - Department of Medicine, Golden Jubilee National Hospital, Glasgow, Scotland. FAU - Cohen, David J AU - Cohen DJ AD - Saint-Luke's Mid America Heart Institute and University of Missouri-Kansas City School of Medicine, Kansas City, Missouri. FAU - Stone, Gregg W AU - Stone GW AD - Columbia University Medical Center, New York Presbyterian Hospital and the Cardiovascular Research Foundation, New York, New York. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20150325 PL - United States TA - Catheter Cardiovasc Interv JT - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions JID - 100884139 SB - IM CIN - Catheter Cardiovasc Interv. 2015 Jul;86(1):40-1. PMID: 26097054 MH - Acute Coronary Syndrome/diagnostic imaging/economics/*surgery MH - Costs and Cost Analysis MH - Female MH - *Hospital Costs MH - Humans MH - Intraoperative Complications/*economics MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*adverse effects MH - Radiography MH - Thrombosis/*economics/etiology MH - Treatment Outcome OTO - NOTNLM OT - coronary artery disease OT - economics/cost-effectiveness OT - percutaneous coronary intervention EDAT- 2015/03/03 06:00 MHDA- 2016/03/24 06:00 CRDT- 2015/03/03 06:00 PHST- 2014/10/31 00:00 [received] PHST- 2015/02/26 00:00 [accepted] PHST- 2015/03/03 06:00 [entrez] PHST- 2015/03/03 06:00 [pubmed] PHST- 2016/03/24 06:00 [medline] AID - 10.1002/ccd.25909 [doi] PST - ppublish SO - Catheter Cardiovasc Interv. 2015 Jul;86(1):30-9. doi: 10.1002/ccd.25909. Epub 2015 Mar 25.