| Objective Unstable angina pectoris (UAP) is one type of the Acute coronary syndrome (ACS). The medication for UAP includes antiplatelet, anticoagulation, vasodilation and relieving coronary constriction. Recently, percutaneous coronary intervention (PCI) has been used to treat UAP. PCI is characterized by rapidity and dramatic effective. The conservative therapy of UAP is simple, easy and inexpensive. At present, the relation between high cost of health care and clinic effectiveness has been becoming the concern focus. The objective of this study is to compare and analyze the effect and cost effectiveness of the conservative treatment and PCI for UAP.Methods This is an observing cohort study. The 215 patients with UAP were selected from the patients treated in our hospital from January 1st of 1998 to August 31st of 2003, in which, there were 148 (68.8%) males and 67 (31.2%) females. The average age was 69.00+10.18 (31 -84) years. According different therapies, the patients were classed into conservative group and PCI group, and risk stratification was studied in the two groups. The clinical outcomes and costs in hospitalization and follow-up period were compared by data analysis.Results (Dm hospital period, there were no significant differences between the two groups in echocardiographic examination (UCG), myocardial enzymes (CPK CK-MB and cTnl), TC and TG (P>0.05). (2) In hospital period, the rate of coronary events in the PCI group(28.4%) and in the conservative group(38.1%) showed no significant difference . The rates of angina were respectively 48.9%, 42.9%, 53.0% , 47.9% in the PCI group and 59.6% , 53.5% , 60.0% , 54.2% in the conservative group showed no significant differences in follow-up duration. (3) The rates of heart failure in hospital period had no significant difference between the PCI group (1.0%) and the conservative one (2.7%). In the follow-up periods, the rates of heart failure were lower in the PCI group (7.6%, 8.3% and 9.1%) than those in the conservative group (24.2%, 25.2% and 27.8%) .The accumulated rate of heart failure was lower in the PCI group (16.3%) than the conservative group (31.3%). In the high-risk patients, the rate of heart failure in the PCI group was lower than that in the conservative one (12.8% and 30.8%). In the intermediate-risk patients, the rate was similar to the high-risk patients (14.8% and 41.7%). (4) The mortality in hospital days was 1.0% in the PCI group and 0.9% in the conservative one (P>0.05). During the follow-up period, the result was analogous. (5) The days in hospital had no significant difference between PCI group and conservative group. (6) During the follow-up periods , the scoring oflife quality in PCI group were higher than that in conservative group (70.22+ 11.89 vs 63.42+14.35, 70.52+ 11.99 vs 63.84+ 14.54, 70.32+11.83 vs 64.08 +13.78, 71.58+10.90 vs 63.10 + 15.76 ). (7) The rates of re-hospitalization between the PCI group and the conservative group (3.3 %vs 4.0%, 7.1 %vs5.1 %, 1.5%vs2.2%, 10.4%vs 6.0%) had no significant differences . (8) The rate of intervention or CABG in the conservative group was higher than the PCI group in the third month (16.2% vs 1.1%). But there were no significant differences in the 6th month, the 12th month and the 24th month. In the high-risk patients, the rate was lower in the PCI group than the conservative one (2.6% and 25.0%). (9) The cost during hospital [M(Qn)] of PCI group was higher than that in conservative group, (6036.400 7830.070 9472.920 vs 51550.103 56368.785 71911.558)yuan. During the follow-up period, because the rate of the intervention or CABG increased in the conservative group, the cost of the PCI group was lower than the conservative one. The costs of the PCI group and the conservative group were (900.00 1300.00 2100.00 vs 750.00 1800.00 3000.00)yuan in the third month , (1800.00 3000.00 4725.00 vs 1620.00 3600.00 8000.00)yuan in the 6th month , (3000.00 5700.00 9089.00 vs 3600.00 8000.00 15879.08) yuan in the 12th month and (4800.00 9600.00 15650.00 vs 6120.00 13200.00 49500.00) yuan in th... |
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