Our Summary

This research paper is about an analysis of the cost-effectiveness of two types of treatments for coronary artery disease (a common heart condition). The two treatments are Coronary Arteries Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI) with a drug stent. The study involved 410 patients in southern Iran who underwent either of these treatments.

The researchers found that while the overall cost of CABG was higher than PCI, the cost of hospital stay, medication, hotel stay and travel was lower for CABG. Also, patients who underwent CABG had less lost productivity.

Furthermore, from the patients’ perspective, CABG was more cost-saving, reducing costs by $16,581 to $34,543 for every increase in effectiveness. Therefore, the study concluded that under the same conditions, CABG is a more cost-effective treatment for coronary artery disease.

FAQs

  1. What are the two types of treatments for coronary artery disease discussed in this research paper?
  2. How is CABG more cost-effective than PCI according to the study?
  3. What aspects make the overall cost of CABG lower compared to PCI?

Doctor’s Tip

A helpful tip a doctor might tell a patient about CABG is to follow a healthy lifestyle after the surgery to improve the long-term success of the procedure. This includes maintaining a balanced diet, regular exercise, quitting smoking, and managing stress levels. Additionally, it is important to attend follow-up appointments and take prescribed medications as directed to ensure optimal recovery and prevent future heart issues.

Suitable For

Patients who are typically recommended CABG are those with severe coronary artery disease, particularly those with multiple blockages in their coronary arteries that cannot be effectively treated with PCI. These patients may have symptoms such as chest pain (angina) or shortness of breath, and may be at high risk for heart attack or other complications. Additionally, patients with diabetes, left main coronary artery disease, or other high-risk factors may also be recommended for CABG. Ultimately, the decision to recommend CABG is based on a thorough evaluation of the patient’s overall health, the extent and severity of their coronary artery disease, and their individual risk factors.

Timeline

Before CABG:

  • Patient experiences symptoms of coronary artery disease such as chest pain, shortness of breath, and fatigue.
  • Patient undergoes diagnostic tests such as angiography to determine the extent of blockages in the coronary arteries.
  • Patient may undergo lifestyle changes, medication therapy, and/or PCI with a drug stent as initial treatment options.

After CABG:

  • Patient undergoes pre-operative assessments and preparations for surgery, including blood tests, imaging tests, and consultations with healthcare providers.
  • Patient undergoes CABG surgery, which involves taking a healthy blood vessel from another part of the body and attaching it to the blocked coronary artery to bypass the blockage.
  • Patient is monitored in the intensive care unit post-surgery for a few days before being transferred to a regular hospital room.
  • Patient undergoes cardiac rehabilitation to help with recovery and improve heart health.
  • Patient may need to make lifestyle changes, take medications, and attend follow-up appointments to monitor their heart health.

Overall, the patient experiences a period of recovery and rehabilitation after CABG, with the goal of improving heart function and reducing symptoms of coronary artery disease.

What to Ask Your Doctor

  1. What are the risks and benefits associated with CABG compared to PCI with a drug stent?
  2. How long is the recovery period for CABG and what kind of follow-up care will be needed?
  3. Are there any lifestyle changes or medications that will be necessary after undergoing CABG?
  4. How often will follow-up appointments be needed after the procedure?
  5. What is the success rate of CABG in treating coronary artery disease?
  6. Are there any alternative treatment options to consider besides CABG?
  7. How will the cost of CABG be covered by insurance or other payment options?
  8. What factors should be taken into consideration when deciding between CABG and PCI with a drug stent for treating coronary artery disease?
  9. How experienced is the medical team in performing CABG procedures and what is their success rate?
  10. Are there any potential long-term effects or complications that could arise from undergoing CABG?

Reference

Authors: Fakhrzad N, Barouni M, Goudarzi R, Kojuri J, Jahani Y, Tasavon Gholamhoseini M. Journal: Cost Eff Resour Alloc. 2023 Feb 15;21(1):16. doi: 10.1186/s12962-023-00426-y. PMID: 36793078