Maria Mori Brooks

Medical Care Costs and Quality of Life after Randomization to Coronary Angioplasty or Coronary Bypass Surgery

BACKGROUND Randomized trials comparing coronary angioplasty with bypass surgery in patients with multivessel coronary disease have shown no significant differences in overall rates of death and myocardial infarction. We compared quality of life, employment, and medical care costs during five years of follow-up among patients treated with angioplasty or bypass surgery. METHODS A total of 934 of the 1829 patients enrolled in the randomized Bypass Angioplasty Revascularization Investigation participated in this study. Detailed data on quality of life were collected annually, and economic data were collected quarterly. RESULTS During the first three years of follow-up, functional-status scores on the Duke Activity Status Index, which measures the ability to perform common activities of daily living, improved more in patients assigned to surgery than in those assigned to angioplasty (P<0.05). Other measures of quality of life improved equally in both groups throughout the follow-up period. Patients in the angioplasty group returned to work five weeks sooner than did patients in the surgery group (P<0.001). The initial mean cost of angioplasty was 65 percent that of surgery (

Coronary Revascularization in Diabetic Patients A Comparison of the Randomized and Observational Components of the Bypass Angioplasty Revascularization Investigation (BARI)

21,113 vs.

Outcomes of Patients With Chronic Renal Insufficiency in the Bypass Angioplasty Revascularization Investigation

32,347, P<0.001), but after five years the total medical cost of angioplasty was 95 percent that of surgery (

Translating the Diabetes Prevention Program: A Comprehensive Model for Prevention Training and Program Delivery

56,225 vs.

Liberal versus restrictive transfusion thresholds for patients with symptomatic coronary artery disease.

58,889), a difference of

Long-Term Clinical Outcome in the Bypass Angioplasty Revascularization Investigation Registry Comparison With the Randomized Trial

2,664 (P = 0.047). The five-year cost of angioplasty was significantly lower than that of surgery among patients with two-vessel disease (

Improved outcomes for women undergoing contemporary percutaneous coronary intervention: A report from the national heart, lung, and blood institute dynamic registry☆

52,930 vs.

Beta-blocker therapy in the cardiac arrhythmia suppression trial

58,498, P<0.05), but not among patients with three-vessel disease (

The Effect of Previous Coronary-Artery Bypass Surgery on the Prognosis of Patients with Diabetes Who Have Acute Myocardial Infarction

60,918 vs.

Contemporary Percutaneous Coronary Intervention Versus Balloon Angioplasty for Multivessel Coronary Artery Disease A Comparison of the National Heart, Lung and Blood Institute Dynamic Registry and the Bypass Angioplasty Revascularization Investigation (BARI) Study

59,430). After five years of follow-up, surgery had an overall cost-effectiveness ratio of