Authors' objectives:

Previous studies have shown that percutaneous coronary intervention (PCI) is a better treatment than thrombolysis for patients with acute myocardial infarction admitted to an invasive centre. However, the economic consequences of PCI as the primary strategy have not yet been assessed. One should also consider different strategies when there is a long distance between the local hospital and the centre offering PCI. The aim of the study was to explore the long-term cost-effectiveness of PCI.

Authors' recommendations: PCI seems to entail greater health benefits at lower costs than thrombolysis whether the patients live close to PCI hospital or not. The conclusion is unchanged after sensitivity analysis. However, a change to primary PCI as a strategy will have consequences for personnel and organisation of the health care system. These secondary consequences have not been considered in these analyses. In clinical practice combined strategies are actual, that is thrombolysis in ambulance or in local hospital before sending the patient to an invasive centre for PCI. For the present, the clinical data supporting an analysis of combined strategies are still too weak to be analysed by our model. When more robust data are available, it will be possible to modify the model to include combinations.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nokc.no/filer/rapport3.04.pdf

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Norway

Organisation Name: Norwegian Institute of Public Health

Contact Address: Universitetsgata 2, Postbox 7004 St. Olavs plass, NO-0310 Oslo NORWAY. Tel: +47 23 25 50 00; Fax: +47 23 25 50 10;

Contact Name: Berit.Morland@nokc.no, dagny.fredheim@nokc.no

Contact Email: Berit.Morland@nokc.no, dagny.fredheim@nokc.no

Copyright: The Norwegian Knowledge Centre for the Health Services