This Article Full Text Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by SoRelle, R. Search for Related Content PubMed PubMed Citation Articles by SoRelle, R.

(Circulation. 2003;108:e9077.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Determining the "CADILLAC" of Care

Primary stenting, already accepted as a more effective measure of reducing death, reinfarction, or the need for early recanalization of coronary arteries, is also cost-effective, said primary investigators of the CADILLAC (Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications) trial in a report in this week’s issue of the journal Circulation ( Circulation. 2003;108:2857–2863[Abstract/Free Full Text]). However, the cost-effectiveness of the glycoprotein IIb/IIIa inhibitor abciximab is equivocal, said the group, led by author Ameet Bakhai, MD, of Harvard Clinical Research Institute in Cambridge, Mass.

In the CADILLAC study, 1703 patients were randomized to stenting versus balloon angioplasty with abciximab versus balloon angioplasty with no abciximab, according to a 2x2 factorial design. The researchers calculated cost per quality-adjusted year of life on the basis of total 1-year costs and lifetime incremental cost-effectiveness ratios. Stenting increased procedural costs by $1148 and initial hospital costs by $1384 over balloon angioplasty. However, stenting also reduced the need for repeat revascularization and reduced follow-up medical care costs by $1215, meaning that at 1 year, the costs for the angioplasty and stent groups were almost the same ($18 690 for angioplasty and $18 859 for stent).

Abciximab increased initial procedural costs by $1122, but most of the drug costs were offset by accelerated discharge from the hospital (0.6 days earlier in the abciximab group). However, the offset did not continue at 1 year, when aggregate costs in the drug group were $1244 more than for those who received standard therapy. Abciximab was . . . [Full Text of this Article]