Publications [#197778] of Daniel B. Mark

Papers Published

1. DB Mark, WW O'Neill, B Brodie, R Ivanhoe, W Knopf, G Taylor, JH O'Keefe, CL Grines, L Davidson-Ray, JD Knight, Baseline and 6-month costs of primary angioplasty therapy for acute myocardial infarction: results from the primary angioplasty registry., Journal of the American College of Cardiology, vol. 26 no. 3 (September, 1995), pp. 688-95, ISSN 0735-1097
   (last updated on 2011/11/29)

   Abstract:
   OBJECTIVE: This study sought to describe the economic outcomes from a prospective multicenter registry of primary coronary angioplasty. BACKGROUND: Interest in coronary angioplasty without preceding thrombolytic therapy as a primary reperfusion strategy has increased as a result of three recent randomized trials showing outcomes equivalent to or better than standard thrombolytic therapy. METHODS: The Primary Angioplasty Registry enrolled 270 patients with acute myocardial infarction at six private tertiary care medical centers. Baseline and follow-up medical costs and counts of resources consumed were collected from enrollment to the 6-month follow-up visit. Correlates and predictors of cost were identified with multivariable linear regression modeling. RESULTS: Ninety-five percent of patients had a revascularization procedure during the baseline hospital period: 85% had coronary angioplasty only; 4% had coronary bypass surgery only; 6% had both procedures. The total mean baseline hospital cost (not charge) was $13,113, with mean physician fees of $5,694. During the follow-up period, repeat coronary angiography was performed in 21% of patients, whereas 13% had repeat angioplasty and 3% bypass surgery. Mean hospital follow-up costs were $3,174, with mean physician fees of $1,443. Independent correlates of higher baseline hospital costs included older age (p = 0.049), anterior infarction (p = 0.03), initial Killip class (p < 0.0001), more severe coronary disease (p = 0.0015), need for bypass surgery alone or in addition to angioplasty (p < 0.0001) and recurrent ischemia (p < 0.0001). CONCLUSIONS: Costs of primary angioplasty for patients with acute myocardial infarction eligible for thrombolysis were strongly influenced by infarction- and procedure-related complications but only modestly influenced by patient selection factors.

   Keywords:
   Adult • Aged • Aged, 80 and over • Angioplasty, Balloon, Coronary • Coronary Artery Bypass • Female • Follow-Up Studies • Hospital Charges • Hospital Costs • Humans • Length of Stay • Male • Middle Aged • Multivariate Analysis • Myocardial Infarction • Outcome Assessment (Health Care) • Prospective Studies • Quality of Life • Registries* • Time Factors • United States • economics • economics* • statistics & numerical data • therapy