Literature DB >> 10728031

Time to treatment and cost of thrombolysis: a multicenter comparison of tPA and rPA.

A Seyedroudbari1, E R Kessler, A N Mooss, R L Wundeman, M Bala, D E Hilleman.   

Abstract

STUDY
OBJECTIVE: This study reports a comparison of the time to treatment and cost of administration of alteplase (tPA) and reteplase (rPA) in patients with acute myocardial infarction (MI).
DESIGN: Retrospective chart review.
SETTING: Hospital emergency department.
INTERVENTIONS: A retrospective chart review of 500 MI patients who received alteplase or reteplase was performed. A comparison of time from presentation in the emergency department to start of treatment was performed, and the cost of administration of drugs, including cost of supplies, monitoring time, and IV line complications, was calculated for each drug.
RESULTS: The time from presentation to start of treatment was significantly shorter for reteplase than alteplase (51 vs 34 min). This difference resulted from a shorter decision to treat to start of treatment time for reteplase (11 min) compared to alteplase (31 min). The cost of administration of alteplase ranged from $136 to $184 per patient, while the cost of administration of reteplase ranged from $87 to $120 per patient. DISCUSSION: Given the similar safety and efficacy profiles of these thrombolytic agents, the advantages of reteplase in speed of administration and the reduction in cost should be considered when making formulary and drug product selection decisions.). Abbreviated Abstract. Alteplase (tPA) and reteplase (rPA) were compared in a retrospective review of 500 patients. rPA was associated with 17 minute time savings from presentation-to-treatment compared to tPA. rPA was also associated with a per patient cost savings $49 to $64 compared to tPA. The time and cost advantages of rPA should be considered when making drug product selection decisions.

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Year:  2000        PMID: 10728031     DOI: 10.1023/a:1018797411812

Source DB:  PubMed          Journal:  J Thromb Thrombolysis        ISSN: 0929-5305            Impact factor:   2.300


  13 in total

1.  A comparison of reteplase with alteplase for acute myocardial infarction.

Authors: 
Journal:  N Engl J Med       Date:  1997-10-16       Impact factor: 91.245

2.  Clinical experience with primary percutaneous transluminal coronary angioplasty compared with alteplase (recombinant tissue-type plasminogen activator) in patients with acute myocardial infarction: a report from the Second National Registry of Myocardial Infarction (NRMI-2).

Authors:  A J Tiefenbrunn; N C Chandra; W J French; J M Gore; W J Rogers
Journal:  J Am Coll Cardiol       Date:  1998-05       Impact factor: 24.094

Review 3.  Thrombolysis for acute myocardial infarction.

Authors:  H D White; F J Van de Werf
Journal:  Circulation       Date:  1998-04-28       Impact factor: 29.690

4.  Use of alteplase for myocardial infarction in two community hospitals.

Authors:  D W Krichbaum; G Grabavoy; R C Finley; I Hamid
Journal:  Am J Hosp Pharm       Date:  1990-07

5.  ACC/AHA guidelines for the management of patients with acute myocardial infarction. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction).

Authors:  T J Ryan; J L Anderson; E M Antman; B A Braniff; N H Brooks; R M Califf; L D Hillis; L F Hiratzka; E Rapaport; B J Riegel; R O Russell; E E Smith; W D Weaver
Journal:  J Am Coll Cardiol       Date:  1996-11-01       Impact factor: 24.094

6.  An analysis of time delays preceding thrombolysis for acute myocardial infarction.

Authors:  S W Sharkey; D D Bruneete; E Ruiz; W T Hession; D G Wysham; I F Goldenberg; M Hodges
Journal:  JAMA       Date:  1989-12-08       Impact factor: 56.272

Review 7.  A fresh look at the molecular pharmacology of plasminogen activators: from theory to test tube to clinical outcomes.

Authors:  R W Smalling
Journal:  Am J Health Syst Pharm       Date:  1997-11-15       Impact factor: 2.637

8.  Factors influencing the time to thrombolysis in acute myocardial infarction. Time to Thrombolysis Substudy of the National Registry of Myocardial Infarction-1.

Authors:  C T Lambrew; L J Bowlby; W J Rogers; N C Chandra; W D Weaver
Journal:  Arch Intern Med       Date:  1997 Dec 8-22

9.  Time from symptom onset to treatment and outcomes after thrombolytic therapy. GUSTO-1 Investigators.

Authors:  L K Newby; W R Rutsch; R M Califf; M L Simoons; P E Aylward; P W Armstrong; L H Woodlief; K L Lee; E J Topol; F Van de Werf
Journal:  J Am Coll Cardiol       Date:  1996-06       Impact factor: 24.094

10.  Hospital delays and problems with thrombolytic administration in patients receiving thrombolytic therapy: a multicenter prospective assessment. Virginia Thrombolytic Study Group.

Authors:  E R Gonzalez; L A Jones; J P Ornato; G C Bleecker; M J Strauss
Journal:  Ann Emerg Med       Date:  1992-10       Impact factor: 5.721

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  1 in total

Review 1.  Paramedics and pre-hospital management of acute myocardial infarction: diagnosis and reperfusion.

Authors:  S Johnston; R Brightwell; M Ziman
Journal:  Emerg Med J       Date:  2006-05       Impact factor: 2.740

  1 in total

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