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J Am Coll Cardiol, 2006; 47:529-537, doi:10.1016/j.jacc.2005.08.070 (Published online 13 January 2006).
© 2006 by the American College of Cardiology Foundation
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The Role of Risk Stratification in the Decision to Provide Upstream Versus Selective Glycoprotein IIb/IIIa Inhibitors for Acute Coronary Syndromes

A Cost-Effectiveness Analysis

Ruchira Glaser, MD*,*, Henry A. Glick, PhD{dagger}, Howard C. Herrmann, MD, FACC* and Stephen E. Kimmel, MD, MSCE, FACC*,{ddagger}

* Division of Cardiovascular Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
{dagger} University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
{ddagger} Center for Clinical Epidemiology and Biostatistics and Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania


Figure 1
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  		Figure 1 Decision tree comparing upstream early use of tirofiban or eptifibatide in all patients versus selective use of abciximab in patients undergoing percutaneous coronary intervention (PCI). Squares = decision; circles = chance events; triangles = outcomes. ACS = acute coronary syndrome; CABG = coronary artery bypass grafting; MI = myocardial infarction.

 

Figure 2
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  		Figure 2 Cost effectiveness of upstream glycoprotein IIb/IIIa use according to Thrombolysis In Myocardial Infarction (TIMI) risk score of patient.

 

Figure 3
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  		Figure 3 Benefits of upstream versus selective glycoprotein (GP) IIb/IIIa use by rates of percutaneous coronary intervention (PCI). CE = cost effectiveness.

 




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