Cath Lab Digest - April 2008 - (Page 49)

APRIL 2008 TCT NEWS 49 The American College of Cardiology (ACC) Scientific Session and the Society of Cardiovascular Angiography & Interventions (SCAI) Annual Scientific Sessions in Partnership with the ACC i2 Summit March 29-April 1, 2008; Chicago, Illinois Study Finds Economic Advantages for 64-Slice CT, SPECT Concludes History of CAD a Factor in Economic Effectiveness of Non-Invasive Methods A multi-center study has found the cost savings of the two leading non-invasive methods for detecting coronary artery disease (CAD) varies based on the patient’s heart history. The study found that patients who underwent coronary computed tomographic angiography (CCTA), without a prior diagnosis of CAD, incurred costs $603 lower (per patient average) than those who underwent myocardial perfusion imaging (MPI or SPECT). Both groups had equal clinical outcomes. However, patients with known CAD who underwent MPI incurred healthcare costs $2,451 lower (per patient average) than CCTA patients with equal clinical outcomes. These results suggest that CCTA may be a cost-efficient alternative in patients without a prior CAD diagnosis. New York Presbyterian/Weill Cornell Cardiologist Dr. James K. Min presented the findings April 1st at the 57th Annual Meeting of the American College of Cardiology in Chicago. “These are exciting data,” said Min. “This provides an initial foundation to suggest that CCTA may be used as a cost-efficient alternative to nuclear stress testing for evaluation of patients with suspected coronary artery disease.” Recently, the Centers for Medicare and Medicaid Services (CMS) assigned transaction codes (T-codes) for CT dedicated to coronary angiography. Looking at multi-center payer claims from five health plans with memberships of at least 10 million people, the study examined cost effectiveness for patients undergoing CCT under “T-codes,” compared to matched patients undergoing MPI testing. Researchers collected data for 142,535 patients who underwent CCT or MPI for 9 months before and after the test. Pre-test cardiac risk was assessed by cardiac risk factors and medications. MPI patients were matched to CCT patients using 11 categories of demographic and risk states. Cost and clinical effectiveness were measured in both downstream CAD costs and clinical events including myocardial infarction (MI), angina and CAD-related hospitalization. ■ Study Finds Taxus® Drug-Eluting Stent Beneficial in Treatment of Large Vessels Results from TAXUS IV and V Randomized Clinical Trials Favor DES Compared to Bare-metal Stents B oston Scientific Corporation welcomed favorable outcomes of one-year data from the company’s TAXUS IV and V randomized clinical trials in patients who received the Taxus® Express™ Paclitaxel-Eluting Coronary Stent System compared to patients who received bare-metal stents (BMS). These results add to the growing body of evidence that paclitaxeleluting stents are clinically beneficial over BMS even in the treatment of large vessels (greater than 3.5 mm), which typically have reduced restenosis risk compared to smaller diameter vessels. David A. Cox, MD, FACC, presented the TAXUS IV and V results at the SCAI Annual Scientific Sessions in Partnership with the ACC/i2 Summit in Chicago. In an analysis of TAXUS IV and V one-year clinical events, Dr. Cox reported that patients treated with the Taxus stent had significant reductions in one-year revascularization rates in both large and small diameter vessels compared to BMS. Although the absolute magnitude of the efficacy benefit was reduced in large-diameter vessels, the relative reduction compared to BMS was maintained. Results include outcomes from 2,458 patients divided into three groups according to maximal device diameter (defined as the diameter of the largest final stent or post-dilatation balloon utilized): <3.5 mm (n=1,528 patients), ≥3.5mm–<4.0mm (n=655), and ≥4.0mm (n=275). Compared to BMS, patients treated with the Taxus stent had lower rates of target lesion revascularization (TLR) at all device diameters: 9.7% vs. 20.4% (p<0.001) for <3.5mm, 4.5% vs. 13.5% (p<0.001) for ≥3.5mm<4.0mm, and 1.6% vs. 6.5% (p 4.0mm. These rates correspond to reductions of 52.5% for the <3.5mm group, 66.7% for the ≥3.5mm– 3.75mm. ■

Table of Contents Feed for the Digital Edition of Cath Lab Digest - April 2008

Cath Lab Digest - April 2008 Kaiser San Rafael Medical Center Orbital Atherectomy: A New Treatment for Complex Peripheral Arterial Disease Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab Contents Clinical Editor’s Corner CEU Education Center The Missing Link in STEMI Interventions — Thrombus Aspiration during Primary Percutaneous Coronary Intervention Predicting Stent Thrombosis Using A Clinical Risk Score Use of a New Guidewire: The Tigerwire Should I Stay or Should I Go? Weighing Options for New Opportunities Navigating Tortuous Coronary Sinus Anatomy Using a Bipolar Lead The National Society of Radiology Practitioner Assistants (NSRPA) Holds 9th Annual Educational Conference For Medical Imaging Physician Extenders and Mid-Level Healthcare Providers Cath Lab & Beyond: A Meeting Update The Ten-Minute Interview with… Dale Hansen RT, CVT Sometimes, You Just Know Twin Circumflex Arteries: A Rare Coronary Artery Anomaly What Do You Think? Meetings Calendar News from the American College of Cardiology (ACC) Scientific Session and the Society of Cardiovascular Angiography & Interventions (SCAI) Annual Scientific Sessions in Partnership with the ACC i2 Summit Clinical & Industry News Cath Laughs Classifieds Advertisers Index

Cath Lab Digest - April 2008

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.