Protocol for an economic evaluation of the randomized controlled trial of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: CULPRIT-SHOCK trial

Quayyum, Z., Briggs, A. , Robles-Zurita, J., Oldroyd, K., Zeymer, U., Desch, S., de Waha, S. and Thiele, H. (2017) Protocol for an economic evaluation of the randomized controlled trial of culprit lesion only PCI vs. immediate multivessel PCI in acute myocardial infarction complicated by cardiogenic shock: CULPRIT-SHOCK trial. BMJ Open, 7(8), e014849. (doi:10.1136/bmjopen-2016-014849) (PMID:28821512) (PMCID:PMC5724099)

[img]
Preview
Text
142109.pdf - Published Version
Available under License Creative Commons Attribution Non-commercial.

743kB

Abstract

Introduction: Emergency percutaneous coronary intervention (PCI) of the culprit lesion for patients with acute myocardial infarctions is an accepted practice. A majority of patients present with multivessel disease with additional relevant stenoses apart from the culprit lesion. In haemodynamically stable patients, there is increasing evidence from randomised trials to support the practice of immediate complete revascularisation. However, in the presence of cardiogenic shock, the optimal management strategy for additional non-culprit lesions is unknown. A multicentre randomised controlled trial, CULPRIT-SHOCK, is examining whether culprit vessel only PCI with potentially subsequent staged revascularisation is more effective than immediate multivessel PCI. This paper describes the intended economic evaluation of the trial. Methods and analysis: The economic evaluation will be conducted using a pre-trial decision model and within-trial analysis. The modelling-based analysis will provide expected costs and health outcomes, and incremental cost-effectiveness ratio over the lifetime for the cohort of patients included in the trial. The within-trial analysis will provide estimates of cost per life saved at 30 days and in 1 year, and estimates of health-related quality of life. Bootstrapping and cost-effectiveness acceptability curves will be used to address any uncertainty around these estimates. Different types of regression models within a generalised estimating equation framework will be used to examine how the total cost and quality-adjusted life years are explained by patients’ characteristics, revascularisation strategy, country and centre. The cost-effectiveness analysis will be from the perspective of each country’s national health services, where costs will be expressed in euros adjusted for purchasing power parity. Ethics and dissemination: Ethical approval for the study was granted by the local Ethics Committee at each recruiting centre. The economic evaluation analyses will be published in peer-reviewed journals of the concerned literature and communicated through the profiles of the authors at www.twitter.com and www.researchgate.net. Trial registration number: NCT01927549; Pre-results.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Robles-Zurita, Dr Jose Antonio and Briggs, Professor Andrew and Oldroyd, Dr Keith and Quayyum, Dr Zahidul
Authors: Quayyum, Z., Briggs, A., Robles-Zurita, J., Oldroyd, K., Zeymer, U., Desch, S., de Waha, S., and Thiele, H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Health Economics and Health Technology Assessment
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:18 August 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BMJ Open 7(8): e014849
Publisher Policy:Reproduced under a Creative Commons license

University Staff: Request a correction | Enlighten Editors: Update this record

Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
629231CULPRIT-SHOCKAndrew BriggsEuropean Commission (EC)602202IHW - HEALTH ECON & TECH ASSESSMENT