Stents for coronary artery disease (CAD)
Chase D, Best L, Milne R
Record ID 31998009121
To provide an overview of the effectiveness and cost-effectiveness of stents for coronary artery disease.
Authors' results and conclusions: There are two proposals: (1) the use of PTCA with elective stenting for patients with CAD and (2) the use of PTCA with stenting for sub-optimal PTCA results for patients with CAD. This report does not consider evidence for the use of bail-out stenting. Two important complications of PTCA are acute coronary occlusion and later restenosis. Intracoronary stents were developed as a means of preventing these complications. The use of stents for patients at risk of acute coronary occlusion is not considered in this report. The use of intracoronary stents in different hospitals varies markedly. The practice of coronary artery stenting is evolving and stents are diffusing rapidly. In 1994/1995, 1,069 PTCAs of the coronary arteries were performed in the South and West region. No more recent data are available. Five RCTs of between 6 and 12 months duration have been published to date which have evaluated elective stenting vs PTCA alone in patients with CAD undergoing PTCA. The largest trial of PTCA with elective stenting found that 10 patients needed to receive PTCA with stenting to prevent one repeat PTCA. Based on this trial, a patient who receives a stent with PTCA gains 0.0053 QALYs more than a patient who receives PTCA alone. No RCTs or non-randomised comparative studies have been published evaluating the use of stents for sub-optimal PTCA results. It was not possible to evaluate the effectiveness of stenting for this indication. The generalisability of published trials is unclear due to dependence on operator skill, narrow inclusion criteria and the lack of longer term follow up.
Authors' methods: Review
Project Status: Completed
URL for project: http://www.wihrd.soton.ac.uk
Year Published: 1998
English language abstract: An English language summary is available
Publication Type: Not Assigned
- Coronary Artery Bypass
- Coronary Disease
- Costs and Cost Analysis
Organisation Name: Wessex Institute for Health Research and Development
Contact Address: Pauline King. Wessex Institute for Health Research and Development, Boldrewood Medical School, Bassett Crescent East, Highfield, Southampton. SO16 7PX Tel. +44 1703 595661 Fax +44 1703 595662
Copyright: Wessex Institute for Health Research and Development (WIHRD)
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