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Reducing the cost of managing patients with atrial fibrillation undergoing percutaneous coronary intervention with stenting

Mehran, Roxana; Vogel, Birgit; Lévy, Pierre (2021), Reducing the cost of managing patients with atrial fibrillation undergoing percutaneous coronary intervention with stenting, journal of Cardiology, 77, 1, p. 93-99. 10.1016/j.jjcc.2020.07.018

Type
Article accepté pour publication ou publié
Date
2021
Journal name
journal of Cardiology
Volume
77
Number
1
Publisher
Elsevier
Pages
93-99
Publication identifier
Metadata
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Author(s)
Mehran, Roxana
Mount Sinai Medical Center
Cardiovascular Research Foundation
Vogel, Birgit
Mount Sinai Medical Center
Lévy, Pierre
Laboratoire d'Economie et de Gestion des Organisations de Santé [Legos]
Laboratoire d'Economie de Dauphine [LEDa]
Abstract (EN)
Patients undergoing percutaneous coronary intervention (PCI) have an increased risk of both ischemic events and bleeding complications resulting from antithrombotic therapy. These events are particularly common in patients with a concomitant indication for oral anticoagulation, such as those with atrial fibrillation, and are associated with a substantial healthcare resource burden. Advances in procedural aspects of PCI have led to marked improvements in outcomes and a consequent reduction in the costs resulting from PCI-associated complications. Furthermore, recent randomized clinical trials have investigated the optimal antithrombotic strategy in the specific case of patients with atrial fibrillation undergoing PCI, leading to a shift toward the tailoring of antithrombotic therapy according to the patient’s individual stroke and bleeding risks. Here we review these recent advances, with a particular focus on the improvements in antithrombotic strategies offered by the non-vitamin K antagonist oral anticoagulants
Subjects / Keywords
Atrial fibrillation; Cost; Percutaneous coronary intervention; Bleeding complications; Thrombosis
JEL
I18 - Government Policy; Regulation; Public Health
I12 - Health Behavior