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Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China.

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Date
2016-04-22
Authors
Jin, Chen
Li, Wei
Qiao, Shu-Bin
Yang, Jin-Gang
Wang, Yang
He, Pei-Yuan
Tang, Xin-Ran
Dong, Qiu-Ting
Li, Xiang-Dong
Yan, Hong-Bing
Wu, Yong-Jian
Chen, Ji-Lin
Gao, Run-Lin
Yuan, Jin-Qing
Dou, Ke-Fei
Xu, Bo
Zhao, Wei
Zhang, Xue
Xian, Ying
Yang, Yue-Jin
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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 article
Subject
Femoral Artery
Radial Artery
Humans
Retrospective Studies
Follow-Up Studies
Middle Aged
Cost-Benefit Analysis
Hospital Costs
China
Female
Male
Coronary Artery Disease
Percutaneous Coronary Intervention
Permalink
https://hdl.handle.net/10161/21715
Published Version (Please cite this version)
10.1161/jaha.115.002684
Publication 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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Ying Xian

Adjunct Associate Professor in the Department of Neurology
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