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Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China.
Abstract
Transradial percutaneous coronary intervention (PCI) has been increasingly adopted
in clinical practice, given its potential advantages over transfemoral intervention;
however, the impact of different access strategies on costs and clinical outcomes
remains poorly defined, especially in the developing world.Using data from a consecutive
cohort of 5306 patients undergoing PCI in China in 2010, we compared total hospital
costs and in-hospital outcomes for transradial intervention (TRI) and transfemoral
intervention. Patients receiving TRI (n=4696, 88.5%) were slightly younger (mean age
57.4 versus 59.5 years), less often women (21.6% versus 33.1%), more likely to undergo
PCI for single-vessel disease, and less likely to undergo PCI for triple-vessel or
left main diseases. The unadjusted total hospital costs were 57 900 Chinese yuan (¥57 900;
equivalent to 9190 US dollars [$9190]) for TRI and ¥67 418 ($10,701) for transfemoral
intervention. After adjusting for all observed patient and procedural characteristics
using the propensity score inverse probability weighting method, TRI was associated
with a lower total cost (adjusted difference ¥8081 [$1283]). More than 80% of the
cost difference was related to lower PCI-related costs (adjusted difference -¥5162
[-$819]), which were likely driven by exclusive use of vascular closure devices in
transfemoral intervention, and lower hospitalization costs (-¥1399 [-$222]). Patients
receiving TRI had shorter length of stay and were less likely to experience major
adverse cardiac events or post-PCI bleeding. These differences were consistent among
clinically relevant subgroups with acute myocardial infarction, acute coronary syndrome,
and stable angina.Among patients undergoing PCI, TRI was associated with lower cost
and favorable clinical outcomes compared with transfemoral intervention.
Type
Journal articleSubject
Femoral ArteryRadial Artery
Humans
Retrospective Studies
Follow-Up Studies
Middle Aged
Cost-Benefit Analysis
Hospital Costs
China
Female
Male
Coronary Artery Disease
Percutaneous Coronary Intervention
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https://hdl.handle.net/10161/21715Published Version (Please cite this version)
10.1161/jaha.115.002684Publication Info
Jin, Chen; Li, Wei; Qiao, Shu-Bin; Yang, Jin-Gang; Wang, Yang; He, Pei-Yuan; ... Yang,
Yue-Jin (2016). Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary
Intervention in China. Journal of the American Heart Association, 5(4). 10.1161/jaha.115.002684. Retrieved from https://hdl.handle.net/10161/21715.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Ying Xian
Adjunct Associate Professor in the Department of Neurology

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