{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T15:08:55Z","timestamp":1768403335499,"version":"3.49.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T00:00:00Z","timestamp":1595203200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Consumers, Health, Agriculture and Food executive agency of the European Commission (EC","award":["EUROTRACS 2012\/1207"],"award-info":[{"award-number":["EUROTRACS 2012\/1207"]}]},{"DOI":"10.13039\/501100004837","name":"Spanish Ministry of Science and Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004837","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Union European Regional Development Funds"},{"name":"ERDF; CIBER of Cardiovascular Diseases","award":["CB16\/11\/00229"],"award-info":[{"award-number":["CB16\/11\/00229"]}]},{"name":"ERDF; CIBER of Cardiovascular Diseases","award":["00246"],"award-info":[{"award-number":["00246"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Department of the Generalitat de Catalunya through the Ag\u00e8ncia de Gesti\u00f3 d\u2019Ajuts Universitaris de Recerca de Catalunya (AGAUR","award":["2017SGR222"],"award-info":[{"award-number":["2017SGR222"]}]},{"name":"Health Research and Innovation Strategic Plan (PERIS","award":["SLT006\/17\/00029"],"award-info":[{"award-number":["SLT006\/17\/00029"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,5,8]]},"abstract":"Abstract<\/jats:title>\n \n Aims<\/jats:title>\n Percutaneous coronary intervention reduces mortality in acute coronary syndrome patients but the cost-utility of increasing its use in elderly acute coronary syndrome patients is unknown.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We assessed the efficiency of increased percutaneous coronary intervention use compared to current practice in patients aged \u226575 years admitted for acute coronary syndrome in France, Germany, Greece, Italy, Portugal and Spain with a semi-Markov state transition model. In-hospital mortality reduction estimates by percutaneous coronary intervention use and costs were derived from the EUROpean Treatment & Reduction of Acute Coronary Syndromes cost analysis EU project (n\u2009=\u200928,600). Risk of recurrence and out-of-hospital all-cause mortality were obtained from the Information System for the Development of Research in Primary Care (SIDIAP) database from North-Eastern Spain (n\u2009=\u200955,564). In-hospital mortality was modelled using stratified propensity score analysis. The 8-year acute coronary syndrome recurrence risk and out-of-hospital mortality were estimated with a multistate survival model. The scenarios analysed were to increase percutaneous coronary intervention use among patients with the highest, moderate and lowest probability of receiving percutaneous coronary intervention based on the propensity score analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n France, Greece and Portugal showed similar total costs\/1000 individuals (7.29\u201311.05 m \u20ac); while in Germany, Italy and Spain, costs were higher (13.53\u201322.57 m \u20ac). Incremental cost-utility ratios of providing percutaneous coronary intervention to all patients ranged from 2262.8 \u20ac\/quality adjusted life year gained for German males to 6324.3 \u20ac\/quality adjusted life year gained for Italian females. Increasing percutaneous coronary intervention use was cost-effective at a willingness-to-pay threshold of 10,000 \u20ac\/quality adjusted life year gained for all scenarios in the six countries, in males and females.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Compared to current clinical practice, broadening percutaneous coronary intervention use in elderly acute coronary syndrome patients would be cost-effective across different healthcare systems in Europe, regardless of the selected strategy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/2047487320942644","type":"journal-article","created":{"date-parts":[[2020,7,21]],"date-time":"2020-07-21T04:41:23Z","timestamp":1595306483000},"page":"408-417","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["A cost-utility analysis of increasing percutaneous coronary intervention use in elderly patients with acute coronary syndromes in six European countries"],"prefix":"10.1093","volume":"28","author":[{"given":"C","family":"Forn\u00e9","sequence":"first","affiliation":[{"name":"Department of Basic Medical Sciences, University of Lleida, Spain"}]},{"given":"I","family":"Subirana","sequence":"additional","affiliation":[{"name":"REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Spain"},{"name":"CIBER Epidemiology and Public Health, Instituto de Salud Carlos III (ISCIII), Spain"}]},{"given":"J","family":"Blanch","sequence":"additional","affiliation":[{"name":"Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Spain"}]},{"given":"J","family":"Ferrieres","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Toulouse University School of Medicine, France"}]},{"given":"A","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Portugal"}]},{"given":"C","family":"Meisinger","sequence":"additional","affiliation":[{"name":"MONICA\/KORA Myocardial Infarction Registry, University Hospital of Augsburg, Germany"},{"name":"Helmholtz Zentrum M\u00fcnchen, German Research Center for Environmental Health, Germany"}]},{"given":"D","family":"Farmakis","sequence":"additional","affiliation":[{"name":"University of Cyprus Medical School, Cyprus"},{"name":"Second Department of Cardiology, University of Athens Medical School, Greece"}]},{"given":"L","family":"Tavazzi","sequence":"additional","affiliation":[{"name":"Maria Cecilia Hospital, GVM Care and Research, Italy"}]},{"given":"M","family":"Davoli","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Lazio Regional Health Service, Italy"}]},{"given":"R","family":"Ramos","sequence":"additional","affiliation":[{"name":"Vascular Health Research Group (ISV-Girona), Jordi Gol Institute for Primary Care Research (IDIAPJGol), Spain"},{"name":"Catalan Institute of Health, Spain"},{"name":"Department of Medical Sciences, University of Girona, Spain"},{"name":"Girona Biomedical Research Institute (IdIBGi), Spain"}]},{"given":"M","family":"Brosa","sequence":"additional","affiliation":[{"name":"Oblikue Consulting SL, Spain"}]},{"given":"J","family":"Marrugat","sequence":"additional","affiliation":[{"name":"REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER) of Cardiovascular Diseases, ISCIII, Spain"}]},{"given":"I R","family":"D\u00e9gano","sequence":"additional","affiliation":[{"name":"REGICOR Study Group, IMIM (Hospital del Mar Medical Research Institute), Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red (CIBER) of Cardiovascular Diseases, ISCIII, Spain"},{"name":"Faculty of Medicine, University of Vic-Central University of Catalonia (UVic-UCC), Spain"}]},{"name":"EUROTRACS 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