| Titre : | Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa blockade in patients undergoing coronary stenting : results from a multicentre randomised trial. (1999) |
| Auteurs : | E.J. TOPOL ; K.M. ANDERSON ; J. BOOTH ; J. BURTON ; C.F. CABOT ; R.M. CALIFF ; E. COHEN ; N. KLEIMAN ; A.M. LINCOFF ; D.B. MARK ; S. SAPP ; D. TALLEY ; Centocor. Inc. Malvern. PA. USA ; Cleveland Clinic Foundation. Cleveland. OH. USA ; Duke University Medical Center. Durham. NC. USA ; Epistent Investigators. INC |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 354, n° 9195, 1999) |
| Pagination : | 2019-2024 |
| Langues: | Anglais |
| Mots-clés : | Cardiopathie coronaire ; Long terme ; Analyse coût efficacité ; Mortalité ; Etude comparée ; Résultat ; Homme ; Appareil circulatoire [pathologie] ; Economie santé |
| Résumé : | [BDSP. Notice produite par INIST R0x7hd86. Diffusion soumise à autorisation]. Background We assessed in a randomised trial the long-term outcomes for potent adjunctive antiplatelet therapy given at the time of coronary stenting. Methods In 63 hospitals in the USA and Canada, 2399 patients were randomly assigned stenting with abciximab, stenting with placebo, or balloon angioplasty with abciximab. Standard adjunctive therapy with aspirin, ticlopidine, and heparin was used. The major outcomes of death and myocardial infarction were assessed at 1-year follow-up by intention to treat. We also investigated the 1-year cost-effectiveness of combined stenting and abciximab therapy. Findings At 1-year follow-up, eight (1.0%) of 794 patients in the stent plus abciximab group had died, compared with 19 (2.4%) of 809 in the stent plus placebo group (hazard ratio 0.43 [95% Cl 0.19-0.97], p=0.037). The combined endpoint of death or large myocardial infarction occurred in 42 (5.3%) and 89 (11.0%), respectively (0.46 [0.32-0.67], p<0.001). By multivariate modelling, the factors independently associated with improved survival were assignment to stenting with abciximab (p=0.027) and greater preprocedural stenosis (p=0.002) ; those associated with worse survival were age greater than 70 years (p<0.001), previous heart failure (p=0.001), diabetes treated with insulin (p=0.02), and postprocedural occlusion (p<0.001). Relative to stenting plus placebo and balloon angioplasty plus abciximab, the incremental 1-year costs of stenting plus abciximab were US$581 and $932. (...) |
Service Documentation EHESP
Me connecter
PORTAIL DOCUMENTAIRE
École des hautes études en santé publique
Catalogue
Multi-bases
Accueil
Sélection de la langue
Adresse
Service Documentation EHESPBibliothèque Rennes Avenue du Professeur Léon Bernard – CS 74312 – 35043 Rennes Cedex Bibliothèque MSSH Paris 20 avenue George Sand - 93210 La Plaine Saint-Denis
France
Bibliothèque Rennes : 02 99 02 29 50 Bibliothèque MSSH Paris : 02 99 02 24 50
contact