ABSTRACT
Most data regarding the impact of restenosis on long-term costs after PCI are derived from clinical trials8-11 or from single-center series.12 Although these studies may not
be applicable to the entire population of patients undergoing PCI, they nonetheless provide several important insights. For example, in the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial, the mean cost for an admission to treat clinical restenosis was US$11 913 (compared with US$10 430 for an index hospitalization). On a population basis, restenosis added an average of US$1675 to each patient’s cost of care during the first year after coronary stenting.11 This value may be regarded as the direct ‘economic burden’ of restenosis in the ESPRIT trial population. Similar findings were noted in the Stent-Primary Angioplasty for Acute Myocardial Infarction (Stent-PAMI) trial of patients with acute myocardial infarction.9 However, higher costs for each episode of clinical restenosis and higher economic burdens were noted in several distinct populations, including patients with in-stent restenosis undergoing treatment in the Gamma-1 trial13 and patients undergoing multivessel PCI12 (Figure 1). These diverse studies demonstrate that just as there is no single ‘restenosis rate’ for all patients who
undergo PCI, there is no single cost or economic burden of restenosis; these values vary substantially according to the specific patient population under investigation.
