RT Journal Article
T1 Economic evaluation of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: the CULPRIT‑SHOCK trial
A1 Robles‑Zurita, José Antonio
A1 Briggs, Andrew
A1 Rana, Dikshyanta
A1 Quayyum, Zahidul
A1 Oldroyd, Keith G.
A1 Zeymer, Uwe
A1 Desch, Steffen
A1 de Waha‑Thiele, Suzanne
A1 Thiele, Holger
K1 Infarto de miocardio - Aspectos económicos
AB Background The CULPRIT-SHOCK trial compared two treatment strategies for patients with acute myocardial infarctionand multivessel coronary artery disease complicated by cardiogenic shock: (a) culprit vessel only percutaneous coronaryintervention (CO-PCI), with additional staged revascularisation if indicated, and (b) immediate multivessel PCI (MV-PCI).Methods A German societal and national health service perspective was considered for three different analyses. The costutility analysis (CUA) estimated costs and quality adjusted life years (QALYs) based on a pre-trial decision analytic modeltaking a lifelong time horizon. In addition, a within trial CUA estimated QALYs and costs for 1 year. Finally, the costeffectiveness analysis (CEA) used the composite primary outcome, mortality and renal failure at 30-day follow-up, and thewithin trial costs. Econometric and survival analysis on the trial data was used for the estimation of the model parameters.Subgroup analysis was performed following an economic protocol.Results The lifelong CUA showed an incremental cost effectiveness ratio (ICER), CO-PCI vs. MV-PCI, of €7010 per QALYand a probability of CO-PCI being the most cost-effective strategy > 64% at a €30,000 threshold. The ICER for the withintrial CUA was €14,600 and the incremental cost per case of death/renal failure avoided at 30-day follow-up was €9010.Cost-effectiveness improved with patient age and for those without diabetes.Conclusions The estimates of cost-effectiveness for CO-PCI vs. MV-PCI have been shown to change depending on the timehorizon and type of economic evaluation performed. The results favoured a long-term horizon analysis for avoiding underestimationof QALY gains from the CO-PCI arm.
PB Springer Nature
YR 2020
FD 2020-10-07
LK https://hdl.handle.net/10630/37213
UL https://hdl.handle.net/10630/37213
LA eng
NO Robles-Zurita, J.A., Briggs, A., Rana, D. et al. Economic evaluation of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: the CULPRIT-SHOCK trial. Eur J Health Econ 21, 1197–1209 (2020). https://doi.org/10.1007/s10198-020-01235-3
NO CULPRIT-SHOCK is a Collaboration Projectfunded by the European Union under the 7th Framework Programmeunder Grant agreement no. 602202 NCT01927549 (ClinicalTrials.govIdentifier).
DS RIUMA. Repositorio Institucional de la Universidad de Málaga
RD 21 ene 2026