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To analyze the effect and cost-effectiveness of Chinese Traditional Medicine-Naoxintong capsule combined with standard dual antiplatelet therapy on patients with CYP2C19 loss-of-function gene mutant after PCI.
529 patients carried at least one loss-of-function (LOF) gene mutant (CYP2C19 *2 or *3) underwent selective PCI were divided into two groups: (1) Dual antiplatelet group (n=271): patients received standard dual antiplatelet therapy. (2) Additional Naoxintong group (n=258): patients received standard dual antiplatelet therapy in concomitant with Naoxintong capsule (3.2g before PCI and 1.6g TID for at least 6 months). We collected clinical data of all patients and followed up he major adverse cardiovascular events (MACE) scheduled in advance (include cardiac death, myocardial infarction, readmission because of unstable angina or progressive angina) and major bleeding events after PCI for 1 year. In addition, we analyze the cost (the sum of antiplatelet drugs cost, hospitalization expense caused by MACE and bleeding events) and cost-effectiveness of the two groups according to the principles of pharmacoeconomic.
1. The incidence of MACE in Dual antiplatelet group and Additional Naoxintong group was 22.5% and 11.2% respectively. The incidence of MACE was significantly lower in Additional Naoxintong group (P=0.001).
2. The incidence of major bleeding events between two groups was similar (P>0.05).
Cost-effectiveness analysis: the cost of Dual antiplatelet group and Additional Naoxintong group was 9585.1 yuan and 10216.5 yuan RMB and Cost-effectiveness ratio was 12448.2 and 11609.7 yuan RMB per caserespectively. Additional Naoxintong group has lower cost-effectiveness ratio than Dual antiplatelet group.
Naoxintong combined with dual antiplatelet therapy could lower down the recurrence of MACE in one year follow-up after PCI in patients carried CYP2C19 LOF allele, it is also a good cost-effective strategy.