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Pradhan A, Vishwakarma P, Bhandari M, Sethi R, Chandra S, Chaudhary G, Sharma A, Perrone MA, Dwivedi S, Narain V. Clinical Outcomes of a Non-Compliant Balloon Dilatation Catheter: MOZEC™ NC Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16231. [PMID: 36498303 PMCID: PMC9738498 DOI: 10.3390/ijerph192316231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/22/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
The present study sought to assess the clinical outcomes of the Mozec™ Non-compliant (NC) Rx PTCA balloon dilatation catheter (BDC) (Meril Life Sciences Pvt. Ltd., Vapi, India) for dilatation of coronary lesions. This was a post-marketing, single-centre, single-arm, retrospective study. In total, 57 patients who had undergone post-dilatation with the Mozec™ NC Rx PTCA balloon dilatation catheter were evaluated. The primary endpoint was procedural success defined as (i) successful delivery of the investigational device to and across the target lesion; (ii) successful inflation, deflation, and withdrawal of the investigational device; (iii) absence of vessel perforation, flow-limiting vessel dissection, increase in thrombolysis in myocardial infarction (TIMI) flow from baseline, clinically significant arrhythmia requiring medical treatment; and (iv) achievement of final TIMI flow grade 3 after percutaneous coronary intervention of the target lesion after single or multiple attempts to cross the target lesion. Procedural success was achieved in 57 (100%) patients. There were no incidences of major adverse cardiac events (MACE)/target lesion failure (TLF). Mozec™ NC Rx PTCA balloon dilatation catheter has demonstrated favourable outcomes for the dilatation of routine and complex coronary lesions in a small cohort, as evidenced by its 100% procedural success rate and absence of MACE.
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Affiliation(s)
- Akshyaya Pradhan
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Pravesh Vishwakarma
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Monika Bhandari
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Rishi Sethi
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Sharad Chandra
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Gaurav Chaudhary
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Akhil Sharma
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Marco Alfonso Perrone
- Department of Cardiology and Cardio Lab, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Sudhanshu Dwivedi
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
| | - Varun Narain
- Department of Cardiology, King George’s Medical University, Lucknow 226003, India
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Hong D, Kim H, Lee H, Lee J, Cho J, Shin D, Lee SH, Kim HK, Choi KH, Park TK, Yang JH, Song YB, Hahn JY, Choi SH, Gwon HC, Kang D, Lee JM. Long-Term Cost-Effectiveness of Fractional Flow Reserve-Based Percutaneous Coronary Intervention in Stable and Unstable Angina. JACC. ADVANCES 2022; 1:100145. [PMID: 38939453 PMCID: PMC11198057 DOI: 10.1016/j.jacadv.2022.100145] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/04/2022] [Accepted: 10/12/2022] [Indexed: 06/29/2024]
Abstract
Background There are limited studies on the cost-effectiveness of fractional flow reserve (FFR)-based percutaneous coronary intervention (PCI) over angiography-based PCI. Objectives The current study sought to evaluate long-term cost-effectiveness of FFR-based PCI compared to angiography-based PCI. Methods A cost-effectiveness analysis was conducted using a nationwide cohort that consisted of patients with stable or unstable angina from the National Health Insurance Service (NHIS) and Health Insurance Review and Assessment (HIRA) database in Korea. The cost-effectiveness analysis was also performed by using a decision and Markov model with key values from the United States and the United Kingdom health care systems. Incremental cost-effectiveness ratio (ICER), an indicator of incremental cost on additional quality-adjusted life-years gained by FFR-based PCI, was evaluated. Results In the NHIS-HIRA data, FFR-based PCI was used during the index PCI in 5,116 patients (3.8%) among 134,613 eligible patients. FFR-based PCI showed significantly lower risk of all-cause death (5.8% vs 7.7%, P = 0.001) and spontaneous myocardial infarction (1.6% vs 2.2%, P = 0.022) than the angiography-based PCI at 4 years. In the NHIS-HIRA data, FFR-based PCI gained 0.039 quality-adjusted life-years at a lower cost ($303) than angiography-based PCI, yielding an ICER of -$7,748 during the 4-year follow-up. FFR-based PCI was dominant in the health care system of Korea (ICER = -$7,309), United States (ICER = -$31,267), and United Kingdom (ICER = -$1,341) during a 10-year time horizon. These results were consistently shown in probabilistic sensitivity analyses. Conclusions In the current cohort, FFR-based PCI was associated with higher quality of life at a lower cost than angiography-based PCI. FFR-based PCI was cost-effective in patients with stable or unstable angina undergoing PCI.
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Affiliation(s)
- David Hong
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyunsoo Kim
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, South Korea
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Hankil Lee
- College of Pharmacy, Ajou University, Suwon, South Korea
| | - Jin Lee
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Juhee Cho
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Doosup Shin
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA
| | - Seung Hun Lee
- Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea
| | - Hyun Kuk Kim
- Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, University of Chosun College of Medicine, Gwangju, South Korea
| | - Ki Hong Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Taek Kyu Park
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young Bin Song
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Joo-Yong Hahn
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seung-Hyuk Choi
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyeon-Cheol Gwon
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Danbee Kang
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, South Korea
| | - Joo Myung Lee
- Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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