경피적 관상동맥중재술 이후 항혈소판제 사용의 경제성 평가 연구: 체계적 문헌고찰

Abstract

Objectives: It is recommended to take oral antiplatelet agents such as aspirin and clopidogrel for a lifetime to reduce the risk of stent thrombosis and recurrent myocardial infarction after coronary stenting. Aspirin is usually recommended, but there is still a lack of evidence whether aspirin is superior to clopidogrel to be taken for a lifetime. In addition, there is a significant price gap between aspirin and clopidogrel in Korea. Therefore, estimating the long-term cost-effectiveness of antiplatelet therapy after percutaneous coronary intervention (PCI) is essential for clinical and health finances. This study aims to systematically review the model-based, long-term economic evaluations of antiplatelet therapy after PCI focused on the features of decision models. Methods: We searched relevant studies using PubMed and reviewed the studies according to the predefined selection/exclusion criteria. Basic characteristics of study, model structures were extracted from the selected studies. Results: A total of 16 decision models on the use of antiplatelet after PCI were identified. Most of them were studies on dual antiplatelet therapy, and only one was on single antiplatelet therapy. Although there were similarities between the models in that there were many studies that include myocardial infarction and stroke, there were variations in the way they reflect these and other health states. Conclusion: The results of this study are expected to serve as basic data when constructing a decision analytic model for the antiplatelet therapy after PCI.