Intravascular Imaging Increases Cost-Effectiveness of Coronary Artery Procedures: AHA

A recent study unveiled the cost-effectiveness of intravascular imaging-guided percutaneous coronary intervention (PCI) compared to conventional angiography-guided procedures. The findings were published in Circulation: Cardiovascular Quality and Outcomes reveal significant benefits for patients with complex coronary artery lesions.

The RENOVATE-COMPLEX-PCI trial was conducted in Korea from May 2018 to May 2021 and examined the clinical and economic outcomes of employing intravascular imaging during PCI procedures. This randomized controlled trial involved a total of 1639 patients and utilized a Markov model to simulate various health states over a 3-year and lifetime horizon.

The results from this research showed compelling evidence in favor of intravascular imaging-guided PCI. Over the 3-year follow-up period, the patients who underwent this advanced technique experienced higher quality-adjusted life years (QALY) and incurred slightly greater medical costs when compared to the individuals who underwent angiography-guided PCI. The incremental cost-effectiveness ratio (ICER) within the trial data stood at $57,040 per QALY gained that fell within the threshold of $35,000 per QALY.

Despite initial higher costs, the long-term analysis revealed a reversal in cumulative medical expenses between the two groups. The patients who underwent intravascular imaging-guided PCI enjoyed consistently higher QALY and also incurred lower total cumulative medical costs that resulted in a dominant incremental cost-effectiveness ratio.

Overall, this study suggests that intravascular imaging-guided PCI is not only clinically beneficial but also more cost-effective in the management of complex coronary artery lesions over the long term. This advanced imaging technology optimizes patient outcomes while minimizing healthcare expenditures by reducing medical costs and improving quality of life.

Reference:

Hong, D., Lee, J., Lee, H., Cho, J., Guallar, E., Choi, K. H., Lee, S. H., Shin, D., Lee, J.-Y., Lee, S.-J., Lee, S. Y., Kim, S. M., Yun, K. H., Cho, J. Y., Kim, C. J., Ahn, H.-S., Nam, C.-W., Yoon, H.-J., … Park, Y. H. (2024). Cost-Effectiveness of Intravascular Imaging-Guided Complex PCI: Prespecified Analysis of RENOVATE-COMPLEX-PCI Trial. In Circulation: Cardiovascular Quality and Outcomes. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1161/circoutcomes.123.010230