Cost-effectiveness of alternative approaches to the management of chronic obstructive coronary artery disease.

: Chronic obstructive coronary artery disease (CAD) is a highly prevalent condition that results in premature mortality as well as substantial morbidity due to angina and reduced quality of life. Various treatment and revascularization strategies are available for managing this condition, including medical therapy, percutaneous coronary intervention, and coronary artery bypass grafting. These treatments are expensive and, given the high prevalence of chronic CAD, there is substantial cost involved in the management of this condition. Recent clinical trials comparing percutaneous coronary intervention with medical management and/or coronary artery bypass grafting, and their associated economic analyses, have generated new information regarding the relative value of these alternative treatment strategies. In this article, we review the basic concepts of cost-effectiveness analysis and the current evidence as it relates to the cost-effectiveness of percutaneous coronary intervention in the management of chronic obstructive coronary artery disease.