Paradigm shifts in cardiovascular medicine

David Holmes, Brian G. Firth, Douglas L. Wood

Research output: Contribution to journalReview article

18 Citations (Scopus)

Abstract

Cardiovascular medicine is changing rapidly with the development, testing, and introduction of new diagnostic and therapeutic methods. New interventional techniques such as the use of drug-eluting stents have important implications for the care of individual patients and the delivery and economics of health care in general. Drug-eluting stents have been shown to improve outcomes among patients undergoing percutaneous coronary intervention by significantly reducing restenosis rates. Two randomized trials have documented that per 100 patients treated with the sirolimus drug-eluting stent, 12.5 to 13.6 patients avoided the need for subsequent target lesion revascularization, when compared with patients treated with conventional stents. The economic effect of the introduction of these stents, which are projected to be two to three times as expensive as conventional stents, is complex and depends on which segment of health care is considered. These stents will be favorably received by patients, physicians, employers, and society as well as payers. However, hospitals may be adversely affected by having increased procedural costs for the stents, along with fewer procedures for evaluation and treatment of restenosis and probably decreased surgical volumes. Drug-eluting stents are only the first of many new technologic advances that will affect cardiovascular care. These procedures have many features in common, including: 1) replacement of major surgical procedures with less invasive approaches; and 2) redistribution of costs, with a decrease in hospital profits but potentially lower costs of health care delivery for society as a whole.

Original languageEnglish (US)
Pages (from-to)507-512
Number of pages6
JournalJournal of the American College of Cardiology
Volume43
Issue number4
DOIs
StatePublished - Feb 18 2004

Fingerprint

Drug-Eluting Stents
Stents
Medicine
Delivery of Health Care
Costs and Cost Analysis
Economics
Sirolimus
Percutaneous Coronary Intervention
Patient Care
Physicians
Therapeutics

Keywords

  • Arterial Revascularization Therapy Study
  • Coronary artery bypass graft surgery
  • Diagnosis-related group
  • Food and Drug Administration
  • International Classification of Diseases-Ninth Revision
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Paradigm shifts in cardiovascular medicine. / Holmes, David; Firth, Brian G.; Wood, Douglas L.

In: Journal of the American College of Cardiology, Vol. 43, No. 4, 18.02.2004, p. 507-512.

Research output: Contribution to journalReview article

Holmes, David ; Firth, Brian G. ; Wood, Douglas L. / Paradigm shifts in cardiovascular medicine. In: Journal of the American College of Cardiology. 2004 ; Vol. 43, No. 4. pp. 507-512.
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