Relevant bibliographies by topics / Coronary heart disease – Treatment – Cost-effectiveness

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Coronary heart disease – Treatment – Cost-effectiveness'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles

Select a source type:

Consult the lists of relevant articles, books, theses, conference reports, and other scholarly sources on the topic 'Coronary heart disease – Treatment – Cost-effectiveness.'

Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.

You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.

Journal articles on the topic "Coronary heart disease – Treatment – Cost-effectiveness"

1

Glick, Henry, Joseph F. Heyse, David Thompson, Robert S. Epstein, M. Eugene Smith, and Gerry Oster. "A Model for Evaluating the Cost-Effectiveness of Cholesterol-Lowering Treatment." International Journal of Technology Assessment in Health Care 8, no. 4 (1992): 719–34. http://dx.doi.org/10.1017/s0266462300002403.

Full text
Abstract:
AbstractWe describe and illustrate the use of a generalizable model for evaluating the cost-effectiveness of alternative cholesterol-lowering treatments. We combine standard incidence-based techniques for measuring the cost of illness with logistic risk functions from the Framingham Heart Study to project, for persons with known coronary risk characteristics, the likelihood of developing coronary heart disease (CHD) over a lifetime as well as a number of related outcomes, including the expected loss of years of life due to CHD, the expected lifetime direct and indirect costs of CHD, and the changes in these outcomes that would result from cholesterol-lowering treatment.
APA, Harvard, Vancouver, ISO, and other styles
2

Franco, Oscar H., Arno J. der Kinderen, Chris De Laet, Anna Peeters, and Luc Bonneux. "Primary prevention of cardiovascular disease: Cost-effectiveness comparison." International Journal of Technology Assessment in Health Care 23, no. 1 (January 2007): 71–79. http://dx.doi.org/10.1017/s0266462307051598.

Full text
Abstract:
Objectives: The aim of this study was to evaluate the cost-effectiveness of four risk-lowering interventions (smoking cessation, antihypertensives, aspirin, and statins) in primary prevention of cardiovascular disease.Methods: Using data from the Framingham Heart Study and the Framingham Offspring study, we built life tables to model the benefits of the selected interventions. Participants were classified by age and level of risk of coronary heart disease. The effects of risk reduction are obtained as numbers of death averted and life-years saved within a 10-year period. Estimates of risk reduction by the interventions were obtained from meta-analyses and costs from Dutch sources.Results: The most cost-effective is smoking cessation therapy, representing savings in all situations. Aspirin is the second most cost-effective (€2,263 to €16,949 per year of life saved) followed by antihypertensives. Statins are the least cost-effective (€73,971 to €190,276 per year of life saved).Conclusions: A cost-effective strategy should offer smoking cessation for smokers and aspirin for moderate and high levels of risk among men 45 years of age and older. Statin therapy is the most expensive option in primary prevention at levels of 10-year coronary heart disease risk below 30 percent and should not constitute the first choice of treatment in these populations.
APA, Harvard, Vancouver, ISO, and other styles
3

Crowley, Steven, David Dunt, and Neil Day. "Cost-effectiveness of alternative interventions for the prevention and treatment of coronary heart disease." Australian Journal of Public Health 19, no. 4 (February 12, 2010): 336–46. http://dx.doi.org/10.1111/j.1753-6405.1995.tb00384.x.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Haq, Iftikhar Ul, Lawrence E. Ramsay, David M. Pickin, Wilfred W. Yeo, Peter R. Jackson, and John N. Payne. "Lipid-Lowering for Prevention of Coronary Heart Disease: What Policy Now?" Clinical Science 91, no. 4 (October 1, 1996): 399–413. http://dx.doi.org/10.1042/cs0910399.

Full text
Abstract:
1. Recent outcome trials suggest that lipid-lowering with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors is justifiable on risk-benefit grounds in subjects with serum cholesterol >5.5mmol/l who have coronary heart disease, other forms of atherosclerotic vascular disease, or who are free of vascular disease but have a risk of major coronary events ≥ 1.5% per year. Choice of an appropriate treatment policy will require (i) knowledge of the proportion of the population who will need treatment for secondary prevention, and (ii) targeting of treatment for primary prevention at a specified absolute risk of coronary heart disease events. Selection of an appropriate coronary heart disease risk for primary prevention requires consideration of the number needed to be treated to prevent one coronary heart disease event, the proportion of the population requiring treatment, the cost-effectiveness of treatment and the total cost of treatment. 2. In a random stratified sample of subjects aged 35–69 years from the Health Survey for England 1993 we first examined the prevalence of subjects with cardiovascular disease and serum cholesterol >5.5 mmol/l who may be candidates for secondary prevention. In those free of cardiovascular disease we then examined the prevalence of subjects with serum cholesterol >5.5 mmol/l who had three different levels of coronary heart disease risk: coronary heart disease event rates of 4.5% per year, 3.0% per year and 1.5% per year. These subjects may be candidates for primary prevention depending on the treatment policy selected. 3. For secondary prevention, 4.8% (95% confidence interval 4.3–5.3) of the U.K. population aged 35–69 years might be candidates for 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor treatment, comprising 2.4% (2.0 to 2.7) with a history of myocardial infarction, 1.9% (1.6 to 2.2) with angina and 0.5% (0.3–0.7) with a history of stroke-all with total cholesterol >5.5 mmol/l. The prevalence of these diagnoses with total cholesterol >5.5 mmol/l increased with age, from 1.5% at age 35–39 years to 16.2% at age 65–69 years in men, and from 0.2% at age 35–39 years to 10.0% at age 65–69 years in women. Approximately 13 people would need treatment for 5 years to prevent one coronary event, at a cost of £36 000 per event prevented. The number needing treatment for secondary prevention would increase substantially if treatment was extended to patients above 70 years of age or to those with serum cholesterol ≤ 5.5 mmol/l. 4. Primary prevention aimed at a coronary event risk of 4.5% per year would lead to treatment of only 0.3% (0.2–0.4) of those aged 35–69 years, and those treated would be predominantly older men with additional risk factors for coronary heart disease. The number needed to be treated and cost per coronary event prevented would be similar to those for secondary prevention. 5. Primary prevention targeted at subjects with a coronary event rate of 3.0% per year would entail treating 3.4% (3.0–3.9) of all those aged 35–69 years. At this level of risk, 20 people would need treatment for 5 years to prevent one coronary event, at a cost of £55 000 per event prevented. 6. Primary prevention aimed at a coronary event rate of 1.5% per year would entail treating 19.6% (18.7–20.6) of all subjects aged 35–69 years, and about 80% of men aged 60–69 years for primary or secondary prevention. At this level of risk, 40 people would need treatment for 5 years to prevent one event, at a cost of £111 000 per event saved. 7. Guidelines for 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor treatment should take into account the considerable workload and financial resources needed to implement secondary prevention of coronary heart disease, the accepted first priority. For primary prevention they need to consider the number needed to be treated to prevent one event, the number of subjects needing treatment, the cost-effectiveness of treatment and the total cost of treatment for the population. Considering only the number needed to be treated we would propose treatment for secondary prevention plus primary prevention at a coronary event rate of 3.0% per year. This would entail treating about 8.2% of the U.K. population aged 35–69 years, at an annual cost for drug therapy alone about £18 million per million of the U.K. population.
APA, Harvard, Vancouver, ISO, and other styles
5

Johannesson, Magnus, Bengt Jönsson, John Kjekshus, Anders G. Olsson, Terje R. Pedersen, and Hans Wedel. "Cost Effectiveness of Simvastatin Treatment to Lower Cholesterol Levels in Patients with Coronary Heart Disease." New England Journal of Medicine 336, no. 5 (January 30, 1997): 332–36. http://dx.doi.org/10.1056/nejm199701303360503.

Full text
APA, Harvard, Vancouver, ISO, and other styles
6

Grubb, Kendra J., Tamim Nazif, Mathew R. Williams, and Isaac George. "Concurrent Coronary Artery and Valvular Heart Disease – Hybrid Treatment Strategies in 2013." Interventional Cardiology Review 8, no. 2 (2013): 127. http://dx.doi.org/10.15420/icr.2013.8.2.127.

Full text
Abstract:
Concomitant coronary artery disease (CAD) and valvular heart disease is an increasingly common problem in the ageing population. Hybrid procedures combine surgical and transcatheter approaches to facilitate minimally invasive surgery or to transform a single high-risk open surgery into two less risky procedures. In ideal circumstances, this strategy may decrease the surgical risk in elderly, high-risk and reoperative surgical candidates, while improving patient comfort, convenience and cost-effectiveness. Hybrid procedures can be performed in a staged fashion or as a ‘one-stop’ procedure in a hybrid operating suite. Increasing evidence supports the safety and short-term efficacy of hybrid valve repair or replacement and coronary revascularisation procedures. Nevertheless, important questions remain, including the optimal timing of the individual procedures and the optimal antiplatelet therapy after percutaneous coronary intervention. With ongoing advances in procedural techniques and anticoagulation strategies, as well as the accumulation of long-term outcomes data, hybrid approaches to concomitant CAD and valvular heart disease will likely become increasingly common.
APA, Harvard, Vancouver, ISO, and other styles
7

Janzon, M. "Cost effectiveness of extended treatment with low molecular weight heparin (dalteparin) in unstable coronary artery disease: results from the FRISC II trial." Heart 89, no. 3 (March 1, 2003): 287–92. http://dx.doi.org/10.1136/heart.89.3.287.

Full text
APA, Harvard, Vancouver, ISO, and other styles
8

Magaz, S., X. Badia, L. Annemans, and M. Lamotte. "PCV64 COST-EFFECTIVENESS ANALYSIS OF CORONARY REVASCULARISATION TECHNIQUES AVAILABLE FOR THE TREATMENT OF ISCHAEMIC HEART DISEASE." Value in Health 6, no. 6 (November 2003): 668. http://dx.doi.org/10.1016/s1098-3015(10)61708-1.

Full text
APA, Harvard, Vancouver, ISO, and other styles
9

Karpov, Yu A. "Coronary heart disease: how to improve the effectiveness of treatment?" Medical Council, no. 16 (September 27, 2018): 46–52. http://dx.doi.org/10.21518/2079-701x-2018-16-46-52.

Full text
Abstract:
A rational combination of drug and invasive management of a patient with stable coronary artery disease can significantly reduce the risk of cardiovascular complications and improve the quality of life. New technologies can significantly improve the results of treatment of these patients only if the prescribed regimens are followed. Meanwhile, adherence to cardiovascular therapy is low, and the task of its increase, in particular the regular use of antiplatelet drugs and statins, is very relevant. One of the effective methods of improving adherence is the appointment of fixed combinations of drugs.
APA, Harvard, Vancouver, ISO, and other styles
10

Zhdan, V. N., Н. S. Khaimenova, M. Yu Babanina, A. I. Katerinchuk, and G. V. Volchenko. "DETERMINING THE EFFECTIVENESS OF THE TREATMENT OF CORONARY HEART DISEASE." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 19, no. 3 (November 8, 2019): 27–30. http://dx.doi.org/10.31718/2077-1096.19.3.27.

Full text
Abstract:
The frequency of the combination of coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD) is highlighted in the work, and it is concluded that there is a fairly significant stratum of patients, namely 25,9%, with combined pathology of the respiratory system and cardiovascular. On the basis of the therapeutic department of the Poltava central regional clinical hospital, 97 patients (84 men and 13 women) with a combination of COPD and CHD were examined: stable angina pectoris, grade II, which were hospitalized due to exacerbation of respiratory pathology. They were divided into 2 groups. Group 1 patients (51 people) received only basic therapy (β2-agonists, anticholinergics, methylxanthines, inhaled glucocorticosteroids, phosphodiesterase-4 inhibitors). In addition to basic therapy, patients of the 2nd group (46 people) were additionally prescribed L-arginine («Tivomax») in the form of a 4,2% solution of 100 ml intravenously once a day for 10 days. As a result of the treatment, a positive dynamics of the regression of clinical manifestations of acute exacerbation of COPD was revealed in both study groups. However, in the second group of subjects who receive L-arginine on the basis of basic therapy, clinical indicators, indicators of the function of external respiration and exercise tolerance, indicators of cardiohemodynamics significantly (p<0,05) improved compared with the control group. It was concluded that the inclusion of L-arginine in the complex treatment of patients with exacerbation of COPD and concomitant CHD increases the effectiveness of the treatment of respiratory pathology and improves cardiodynamics. The addition of L-arginine to complex therapy for patients with COPD in combination with CHD leads to a statistically significant improvement in clinical and instrumental parameters, which is due to the antihypoxic, antiplatelet, cytoprotective and vasodilatory effects, detoxification activity of L-arginine (“Tivomax”), which is safe improves the effectiveness of treatment.
APA, Harvard, Vancouver, ISO, and other styles
More sources

Dissertations / Theses on the topic "Coronary heart disease – Treatment – Cost-effectiveness"

1

Cilliers, Willie. "Cost-effective cardiology in the new national health system in South Africa : a proposal." Thesis, Stellenbosch : University of Stellenbosch, 2009. http://hdl.handle.net/10019.1/987.

Full text
Abstract:
Thesis (MBA (Business Management))--University of Stellenbosch, 2009.
ENGLISH ABSTRACT: South Africa is on the verge of major changes in the private medical sector. The government’s planned National Health Insurance has far reaching implications for all role players in the industry, as well as for the general public. This paper looks at the changes that have been made since the ANC government came to power in 1994 and then continues to look at possible models for the new National Health Insurance plan. A proposal on practicing cost-effective cardiology within this new system is made. The data of a pilot project between a private service provider and a managed healthcare company is analysed as a basis of this discussion.
AFRIKAANSE OPSOMMING: Suid-Afrika se mediese bedryf staan op die vooraand van groot veranderinge. Die regering se beplande Nasionale Gesondheidsplan het verreikende implikasies vir alle rolspelers in die bedryf, sowel as die algemene man op straat. Die dokument kyk oorsigtelik na die veranderinge wat ondergaan is sedert die ANC regering aan bewind gekom het in 1994 en gaan daarna voort om na moontlike opsies te kyk hoe die nuwe gesondheidsmodel daarna gaan uitsien. Voorstelle word gemaak oor hoe privaat kardiologie in die nuwe sisteem koste-effektief beoefen kan word. ‘n Lootsprojek van ‘n privaat diensverskaffer en ‘n bestuurde gesongheidsorg maatskappy se data word ontleed as basis vir die bespreking.
APA, Harvard, Vancouver, ISO, and other styles
2

Henriksson, Martin. "Cost-effectiveness and Value of Further Research of Treatment Strategies for Cardiovascular Disease." Doctoral thesis, Linköping : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-9788.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Brandão, Sara Michelly Gonçalves. "Custo-efetividade e custo-utilidade dos tratamentos clínico, cirúrgico e percutâneo em portadores de doença coronariana multiarterial estável." Universidade de São Paulo, 2018. http://www.teses.usp.br/teses/disponiveis/5/5131/tde-28022019-095319/.

Full text
Abstract:
Introdução - Os custos para o tratamento da doença arterial coronariana (DAC) são altos em todo o mundo. Foi realizada uma análise post hoc de custo-efetividade de três estratégias terapêuticas para DAC multiarterial. Métodos - De maio de 1995 a maio de 2000, um total de 611 pacientes foram aleatoriamente designados para CRM (n = 203), ICP (n = 205) ou TM (n = 203). Este estudo de análise de custos baseou-se na perspectiva do Sistema Público de Saúde. Os custos iniciais de procedimentos e acompanhamento de medicamentos, exames cardiológicos e hospitalizações por complicações foram calculados após a randomização. Anos de vida e anos de vida ajustados pela qualidade (QALY) foram usados como medidas de eficácia. As razões de custo-efetividade incremental (RCEI) foram obtidas usando métodos de bootstrap não paramétricos com 5.000 replicações. Resultados - Os custos iniciais do procedimento foram menores para o TM. No entanto, os custos acumulados de 5 anos foram menores para a CRM. Em comparação com a linha de base, as 3 opções de tratamento produziram melhorias significativas no QALY. Após 5 anos, a ICP e a CRM tiveram melhores resultados de QALY em comparação com o TM. Os resultados da RCEI favoreceram a CRM e a ICP quando comparadas ao TM, já a ICP em relação à CRM foi mais custo-efetiva em 61% para limiares até 3 PIB per capita por QALY. Por outro lado, a análise de sensibilidade mostrou o TM como a terapia preferida em comparação com a CRM e ICP, na análise considerando custos mais elevados. Conclusão - No seguimento de 5 anos, a ICP e CRM mostraram ser os tratamentos com QALYs cumulativos mais altos entre pacientes com DAC multiarterial quando comparados com TM. Além disso, apesar dos custos iniciais serem mais elevados, a comparação de custo-efetividade após 5 anos de acompanhamento entre os 3 tratamentos mostrou que ambas as intervenções (CRM e ICP) são estratégias custo-efetivas em comparação com a TM
Background. The costs for treating coronary artery disease (CAD) are high worldwide. We performed a post hoc analysis of cost-effectiveness of 3 therapeutic strategies for multivessel CAD. Methods. From May 1995 to May 2000, a total of 611 patients were randomly assigned to CABG (n=203), PCI (n=205), or MT (n=203). This cost analysis study was based on the perspective of the Public Health Care System. Initial procedural and follow-up costs for medications, cardiology examinations, and hospitalizations for complications were calculated after randomization. Life-years and quality-adjusted life years (QALY) were used as effectiveness measures. Incremental cost-effectiveness ratios (ICER) were obtained by using nonparametric bootstrapping methods with 5000 resamples. Results. Initial procedural costs were lower for MT. However, the subsequent 5-year cumulative costs were lower for CABG. Compared with baseline, the 3 treatment options produced significant improvements in QALY. After 5 years, PCI and CABG had better QALY results compared with MT. The ICER results favored CRM and PCI when compared to the TM, since the PCI in relation to the CRM was more costeffective in 61% for the thresholds up to 3 GDP per capita per QALY. On the other hand, sensitivity analysis showed MT as the preferred therapy compared with CABG and PCI, in the analysis considering higher costs. Conclusion. At 5-year follow-up, the 3 treatment options yielded improvements in quality of life, with comparable and acceptable costs. However, despite higher initial costs, the comparison of costeffectiveness after 5 years of follow-up among the 3 treatments showed both interventions (CABG and PCI) to be cost-effective strategies compared with MT
APA, Harvard, Vancouver, ISO, and other styles
4

Hsun, Chen Chang, and 陳昶勳. "The cost-effectiveness of lowering serum cholesterol in primary prevention of coronary heart disease." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/20981535396377045900.

Full text
APA, Harvard, Vancouver, ISO, and other styles

Books on the topic "Coronary heart disease – Treatment – Cost-effectiveness"

1

Cutler, David M. The costs and benefits of intensive treatment for cardiovascular disease. Cambridge, MA: National Bureau of Economic Research, 1998.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
2

Afendulis, Christopher C. Tradeoffs from integrating diagnosis and treatment in markets for health care. Cambridge, Mass: National Bureau of Economic Research, 2006.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
3

Sarma, Syam. The gemfibrozil cost-benefit model: Analysis of data from the Helsinki Heart Study, model development, and extension to the California Medicaid population. Santa Monica, CA (1700 Main St., P.O. Box 2138, Santa Monica 90407-2138): RAND, 1993.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
4

Sarma, Syam. The gemfibrozil cost-benefit model: Analysis of data from the Helsinki Heart Study, model development, and extension to the California Medicaid population. Santa Monica, CA (1700 Main St., P.O. Box 2138, Santa Monica 90407-2138): RAND, 1993.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
5

Sarma, Syam. The gemfibrozil cost-benefit model: Analysis of data from the Helsinki Heart Study, model development, and extension to the California Medicaid population. Santa Monica, CA (1700 Main St., P.O. Box 2138, Santa Monica 90407-2138): RAND, 1993.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
6

Sarma, Syam. The gemfibrozil cost-benefit model: Analysis of data from the Helsinki Heart Study, model development, and extension to the California Medicaid population. Santa Monica, CA: RAND, 1993.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
7

Sarma, Syam. The gemfibrozil cost-benefit model: Analysis of data from the Helsinki Heart Study, model development, and extension to the California Medicaid population. Santa Monica, CA (1700 Main St., P.O. Box 2138, Santa Monica 90407-2138): RAND, 1993.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
8

1965-, Noorani Hussein Zafer, and Canadian Coordinating Office for Health Technology Assessment., eds. Coronary stents: Clinical experience and cost-effectiveness. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 1997.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
9

David, Talley J., Mauldin Patrick D, and Becker Edmund R, eds. Cost effective diagnosis and treatment of coronary artery disease. Baltimore, MD: Williams & Wilkins, 1997.

Find full text
APA, Harvard, Vancouver, ISO, and other styles
10

1934-, Brown Allan, and Canadian Coordinating Office for Health Technology Assessment., eds. Economic evaluation of glycoprotein IIb/IIIa inhibitors in patients undergoing percutaneous coronary intervention with stenting. Ottawa: Canadian Coordinating Office for Health Technology Assessment, 2005.

Find full text
APA, Harvard, Vancouver, ISO, and other styles

Book chapters on the topic "Coronary heart disease – Treatment – Cost-effectiveness"

1

Atherly, Adam, and Steven D. Culler. "Issues in the Analysis of Cost-Effectiveness in the Diagnosis and Treatment of Coronary Artery Disease in Women." In Coronary Disease in Women, 413–21. Totowa, NJ: Humana Press, 2004. http://dx.doi.org/10.1007/978-1-59259-645-4_26.

Full text
APA, Harvard, Vancouver, ISO, and other styles
2

Jacobson, Terry A., and Kara L. Marchman. "Improving the Cost Effectiveness of Lipid Lowering Therapy in Coronary Heart Disease Prevention." In Medical Science Symposia Series, 275–84. Dordrecht: Springer Netherlands, 1998. http://dx.doi.org/10.1007/978-94-011-5022-4_32.

Full text
APA, Harvard, Vancouver, ISO, and other styles
3

Berry, Colin, Andrew Davie, and John McMurray. "Cost-effectiveness of statins in primary and secondary prevention of coronary heart disease." In HMG-CoA Reductase Inhibitors, 135–47. Basel: Birkhäuser Basel, 2002. http://dx.doi.org/10.1007/978-3-0348-8135-7_8.

Full text
APA, Harvard, Vancouver, ISO, and other styles
4

Osnabrugge, Ruben L. J., and A. Pieter Kappetein. "Cost-effectiveness." In ESC CardioMed, edited by William Wijns, 1395–99. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0339.

Full text
Abstract:
Approximately 2% of the total healthcare expenditure in the European Union is spent on coronary artery disease and these expenditures are expected to increase. In order to make rational decisions on resource allocation, clinical and economic outcomes of treatment strategies need to be analysed together. Cost-effectiveness studies provide a framework for making such decisions. The early economic studies comparing balloon angioplasty with coronary artery bypass grafting (CABG) show that the early cost benefit of angioplasty is lost at long-term follow-up. CABG provides a clinically and economically attractive treatment option in patients with severe coronary artery disease. Later studies with bare-metal or drug eluting stents showed that the higher invasiveness of CABG leads to a longer hospital stay and higher upfront costs. However, at longer follow-up the cost difference is small and clinical outcomes with CABG are better than with percutaneous coronary intervention (PCI). This makes CABG superior to PCI at long-term follow-up, both clinically and economically in patients with extensive coronary disease. Nevertheless, in patients with less complex coronary artery disease, PCI with drug-eluting stents may be preferred on both clinical and economic grounds. Although reduction in stent price does not have a big impact, several other developments may impact future economic comparisons between PCI and CABG. Newer-generation stents will enhance the clinical and economic profile of PCI. Moreover, better clinical decision-making tools and fractional flow reserve will impact the cost-effectiveness equation.
APA, Harvard, Vancouver, ISO, and other styles
5

Oldenburg, Olaf. "Sleep apnoea: definition, prevalence, and role in cardiovascular diseases." In ESC CardioMed, 1058–62. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0256.

Full text
Abstract:
The two main forms of sleep apnoea are obstructive (OSA) and central (CSA) sleep apnoea. In the presence of cardiovascular disease, CSA can manifest as Cheyne–Stokes respiration. OSA and CSA both can cause substantial oxygen desaturations, alterations in sympathovagal balance, neurohumoral activation, and endothelial dysfunction; OSA also causes marked negative intrathoracic pressure swings, which have a number of undesirable cardiovascular consequences (e.g. increased cardiac transmural pressure gradients, sympathetic activation). OSA is the most common type of sleep apnoea in the general population, but rates are higher in cardiovascular disease. CSA is particularly prevalent in patients with underlying cardiac, neurological, or renal disease. Typical OSA risk factors include obesity, male gender, smoking, and age, while the severity of heart failure is predictive of the prevalence and severity of CSA. Recognition and diagnosis of sleep apnoea can be difficult because patients often do not present with typical symptoms. Sleep apnoea is an important co-morbidity in cardiovascular disease because of links with a number of conditions. OSA is an independent risk factor for the development of hypertension and heart failure, and has a negative impact on the effectiveness of treatments for atrial fibrillation. OSA has also been linked with the development of coronary artery disease, worse outcomes after acute myocardial infarction, and higher event rates in patients with coronary artery disease. CSA with Cheyne–Stokes respiration has important links with heart failure and is a risk factor for poor outcome even when other therapies are optimized. Cheyne–Stokes respiration has also been documented in stroke patients, increasing stroke severity and worsening prognosis.
APA, Harvard, Vancouver, ISO, and other styles
6

Neglia, Danilo, and Juhani Knuuti. "Integration of stress nuclear imaging in the diagnostic and management algorithms of stable coronary artery disease." In ESC CardioMed, edited by Philipp Kaufmann, 589–93. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0124.

Full text
Abstract:
The role of nuclear imaging for the assessment of coronary artery disease (CAD) is well established. In patients with intermediate pre-test probability of CAD, stress single-photon emission computed tomography (SPECT) and positron emission tomography (PET) have good diagnostic accuracy with high sensitivity and good specificity to detect significant disease which render these modalities particularly valuable in patients with higher pre-test probability to avoid the risk of missed diagnosis. These techniques excel in risk stratification, negative findings are associated with a good long-term prognosis while their ability to quantify the extent of myocardial-inducible ischaemia and necrosis allows identification of high-risk patients in whom aggressive medical treatment or revascularization, or both, are warranted to improve outcome. PET is the reference method to quantify myocardial blood flow and flow reserve and more recently this is also possible with new SPECT cameras. Quantitation adds on the diagnostic accuracy of nuclear perfusion studies in obstructive CAD and also allows detection of the functional effects of non-obstructive coronary atherosclerosis as well as recognition of coronary microvascular disease as a cause of inducible ischaemia and symptoms in patients with normal coronary arteries. The combination of SPECT or PET with coronary CT angiography holds promise to allow a comprehensive anatomical–functional characterization of CAD. Dose reduction strategies are now available limiting the potential risk of radiation exposure. More evidence from comparative outcome and cost-effectiveness studies is needed to determine the optimal integration of nuclear imaging in diagnostic and management algorithms in patients with suspected or known stable CAD.
APA, Harvard, Vancouver, ISO, and other styles
7

Iliodromitis, Efstathios K., and Dimitrios Farmakis. "Risk stratification for sudden cardiac death in the general population." In ESC CardioMed, edited by Gerhard Hindricks, 2305–8. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198784906.003.0544.

Full text
Abstract:
There are three main groups in the general population as far as sudden cardiac death (SCD) is concerned: individuals without a known history or predisposing factors for heart disease; individuals with known risk factors for heart disease or SCD; and patients with diagnosed ischaemic, structural, or electrical cardiac conditions, acquired or genetic, that are associated with an increased risk for SCD. Although SCD literature focuses mainly on patients with known heart disease, approximately 50% of SCD cases occur in individuals belonging to the first two groups. The annual incidence of SCD in the general population ranges between 0.6 and greater than 1.4 per 1000 individuals. SCD occurs more commonly in men than in women and with an incidence that increases with age due to the increase in coronary artery disease. The commonest aetiologies for SCD in the general population are coronary artery disease and cardiomyopathy, accounting for 80% and 10–15% of cases, respectively. A number of factors have been related to an increased risk for SCD in the general population including genetic predisposition, risk factors for atherosclerosis, strenuous physical activity and sports, electrocardiographic abnormalities, elevated levels of biomarkers, and abnormalities in imaging and other diagnostic techniques. However, large-scale prospective studies that confirm the feasibility, clinical efficacy, and cost-effectiveness of using these factors for broad mass screening for SCD are generally lacking and therefore risk stratification for SCD in the general population remains challenging.
APA, Harvard, Vancouver, ISO, and other styles
8

Morales-Villegas, Enrique C., and Kausik K. Ray. "PCSK9 Inhibition with Evolocumab Reaching Physiologic LDL-C Levels for Reducing Atherosclerotic Burden and Cardiovascular Disease-The Full Landscape." In Frontiers in Cardiovascular Drug Discovery: Volume 4, 148–85. BENTHAM SCIENCE PUBLISHERS, 2019. http://dx.doi.org/10.2174/9781681083995118040007.

Full text
Abstract:
Physiologically, in the presence of an intracellular deficit of cholesterol, the LDLR synthesis, expression and function increase, thus uptaking and providing cholesterol to the cell. This process is counter-regulated by PCSK9 expression, the protease inducing LDLR proteolysis, thereby limiting its function maintaining a constant cholesterol intracellular concentration. Accordingly, the balance between PCSK9 and LDLR regulates the intracellular concentration of cholesterol and in consequence has impact on circulating LDL-cholesterol. This chapter reviews the brief and amazing recent history with PCSK9 inhibition from basic science to current clinical recommendations for MAbs-PCSK9. In 2003 and 2005, respectively, the pcsk9 gene mutations, determinants of the “gain of function” of PCSK9 and severe hypercholesterolemia, and the pcsk9 gene mutations with “loss of function” of PCSK9, determinants of hypocholesterolemia were described; subsequently, in 2006, the association between the pcsk9 gene mutations and the “loss of function” of PCSK9 with hypocholesterolemia and reduction of up to 88% for the risk of a coronary event in the “mutant” population versus the control population was published. Since evolocumab clinical research program has completed and published their phases I, II and III results including its cardiovascular outcomes trial, this chapter is focused in reviewing the results of evolocumab clinical research program. In 2009, the effect of a “full human” monoclonal antibody vs PCSK9 in mice and non-human primates was first reported; MAb-PCSK9, AMG-145 (evolocumab) produced in cynomolgus monkeys a doubling in the number of LDLR and an average 75% reduction in circulating LDL-cholesterol. In 2012, the first phase I study with evolocumab versus placebo were reported; this program informed very significant reductions in LDLcholesterol in healthy subjects and patients with familial and non-familial hyper cholesterolemia treated without/with statins; tolerability and safety of evolocumab were similar to placebo. With this evidence, the phase II and III investigations with evolocumab initiated; four years later, the OSLER trial allowed us to envisage the following scenario: MAb-PCSK9 evolocumab have a favorable effect on LDLcholesterol, other apo-B100 lipoproteins and overall mortality and myocardial infarction; all the aforementioned with a very favorable safety and tolerability profile. In the same direction, in 2016 was published the GLAGOV trial, wich demonstrates for the first time that the addition of a non-statin therapy -evolocumab- to the optimal treatment with statins is associated with atheroregression; and finally, in 2017, the FOURIER and the EBBINGHAUS trials were presented, wich confirmed that the addition of evolocumab to the optimal treatment with statins is associated with an additional and significant 20% relative risk reduction -26 months of follow-up- for cardiovascular mortality, myocardial infarction and/or ischemic stroke, all without neurocognitive risk. Beyond the currently approved indications by regulatory agencies, considering the high cost of PCSK9 inhibitors and financial restraints within healthcare budgets, for now and before definitive and necessary cost-effectiveness analysis and price optimization are in place, evolocumab is recommended in specific clinical scenarios reviewed in this chapter.
APA, Harvard, Vancouver, ISO, and other styles

Conference papers on the topic "Coronary heart disease – Treatment – Cost-effectiveness"

1

Baca, Justin T., David N. Finegold, and Sanford A. Asher. "Photonic Crystal Sensors for the Rapid Detection of Myocardial Ischemia." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176582.

Full text
Abstract:
Coronary Heart Disease is the leading cause of death in the United States and was responsible for approximately one of every five deaths in 2003 [1]. Unnecessary admissions to US Hospitals of patients with suspected Acute Coronary Syndrome (ACS) is estimated to cost about 12 billion dollars a year [2]. The earliest biochemical markers currently assayed do not appear in the blood for hours after the onset of chest pain; a rapid test for myocardial ischemia would help to expedite treatment and avoid unnecessary hospital admissions [3].
APA, Harvard, Vancouver, ISO, and other styles
2

Киреева, Виктория, Viktoriya Kireeva, Ю. Усольцев, Yu Usolcev, Ж. Капустенская, Zh Kapustenskaya, Е. Кожевникова, et al. "Intermediate results 2016 of a search study of translational diagnostic methods Mitochondrial dysfunction in patients with chronic myocardial ischemia and/or head Brain." In Topical issues of translational medicine: a collection of articles dedicated to the 5th anniversary of the day The creation of a department for biomedical research and technology of the Irkutsk Scientific Center Siberian Branch of RAS. Москва: INFRA-M Academic Publishing LLC., 2017. http://dx.doi.org/10.12737/conferencearticle_58be81ec94893.

Full text
Abstract:
Purpose of the study. To rate prognostic properties of changes in mitochondrial DNA concentration in the blood plasma of patients with chronic cerebral ischemia and ischemic heart disease in relation to the disease and the effectiveness of the therapy. Materials and methods. The study involved patients suffering from coronary heart disease (CHD) and chronic cerebral ischemia (CCI) with stable and unstable atherosclerotic plaques, who have signed informed consent to the data processing within the framework of scientific research. The patients were admitted to the hospital for examination and treatment of CHD and CCI in Cardiology and Neurology Unit of the Hospital of ISC SB RAS. The subjects underwent laboratory and instrumental examination and analysis of the level of free circulating serum mitochondrial DNA by real-time PCR (copies/ml). The examination results considered as satisfactory were compared with the mtDNA levels before and after the treatment. Results. The average value of the mtDNA levels before and after the treatment in patients of neurological and cardiological profile were significantly different: 1 093 686 copies/ml vs 418 046 copies/ml, respectively (p = 0.02). Unlike women, men mtDNA levels statistically significantly (p = 0.03) decreased after the treatment. We revealed statistically significant differences in mtDNA level indicators before and after the treatment, depending on the definition of the series (p = 0.0010) for rank test Kruskal – Wallis test. The results of the proposed research will help to identify prognostic factors of destabilization of cell damage and plaques in endothelial dysfunction, atherosclerosis and its complications, to conduct clinical test of the method for predicting and diagnostics of cellular damage in chronic ischemia on a background of atherosclerosis.
APA, Harvard, Vancouver, ISO, and other styles
3

Fayssal, Iyad, Fadl Moukalled, Samir Alam, Robert Habib, and Hussain Ismaeel. "The Development of a Robust Low Computational Cost Diagnostic Tool to Evaluate Stenosis Functional Significance in Human Coronary Arteries." In ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-51532.

Full text
Abstract:
There is discordance between the anatomic severities of the coronary narrowing and their corresponding functional significance. Fractional Flow Reserve (FFR) is among the physiological parameters invasively measured to assess the hemodynamic significance of a stenosis during maximal hyperemia. FFR values ≤ 0.8 indicate that the downstream heart tissue perfused by this vessel is at risk for ischemia. While measuring FFR is an invasive procedure that is expensive, time consuming, and not without complications, recently, noninvasive estimation of FFR was shown to be possible from comprehensive predictive techniques allowing the computation of in-vivo FFR. However, these non-invasive methods are associated with high computational cost and require high performance computing technology, thus, reducing their wide adoption in clinics. This paper is steered to achieve two main goals: (1) to develop a fast numerical method to aid clinicians assessing ischemia level and determine if coronary revascularization (PCI) is required in human diseased coronary arteries with minimum time and computer resources; (2) to develop a robust method which allows predicting the patient FFR independently of the actual in-vivo physiologic conditions (mainly pressure) of the specific patient. The numerical framework was designed by adopting the finite volume method to generate the discrete model of the Reynolds average form of conservation equations used to predict blood hemodynamics. Two strategies were investigated to reduce computational cost while retaining solution accuracy. The first strategy is based on isolating the diseased artery from its branch tree and simulating it separately without implicitly integrating other arterial segments. A lumped dynamic model with special numerical treatment is coupled to the 3D domain outlet boundary to account for the downstream effects from the vascular bed. The second strategy is based on replacing a full transient simulation by a steady state one performed under mean conditions of pressure and blood volume flow rate. The strategy was applied on a healthy (hypothetical) and stenosed arterial segments with different stenosis severities simulated under rest and hyperemic conditions. An excellent agreement was achieved for FFR values computed from full transient simulations with the ones obtained from steady state simulation (error < 0.2 % was obtained for all test cases). The computational cost for the mean condition scenario was 0.1 that of a full transient simulation. The robustness of the method was tested by varying inflow conditions and reporting their effect on FFR. Interestingly, the predicted ischemia level was not altered when the inlet pressure was increased by 10 % from the base case. An analytical model was derived to explain the FFR independency of patient in-vivo coronary pressure. These promising findings from the numerical tests performed on idealized healthy and stenosed arterial models could significantly impact the applicability of the developed methodology and translating it into future practical clinical applications.
APA, Harvard, Vancouver, ISO, and other styles
4

Lowe, G. D. O. "EPIDEMIOLOGY AND RISK PREDICTION OF VENOUS THROMBOEMBOLISM." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1642965.

Full text
Abstract:
Uses of epidemiology. Venous thromboembolism continues to be an important cause of death and disability in Western Countries. Its epidemiology may provide clues to etiology, e.g. the increased incidence in oral contraceptive users, and the low prevalence at autopsy in Central Africa or Japan compared to the U.S.A. A second use is the monitoring of time-trends: the diagnosis of pulmonary embolism increased during the 1970s, although the case fatality decreased. A third use is the identification and quantification of risk factors: these could be modified in the hope of prevention, or else used to select high risk groups for selective prophylaxis, e.g. during acute illness. Prevention is the only feasible approach to reducing the burden of venous thromboembolism, since most cases are not diagnosed, and since the value of current treatment is debatable.Case definition. Presents problems: clinical diagnosis is unreliable, and should if possible be supported by objective methods. Autopsy studies are performed on selected populations, at a decreasing rate; the frequency of thromboembolism depends on technique; and pathologists cannot be blinded and are open to bias. It can also be difficult to judge whether a patient dying with pulmonary embolism died from pulmonary embolism. 125I-fibrinogen scans indicate minimal disease, and now present ethical problems in screening due to risks of viral transmission. Venography is invasive and is not readily repeatable, which limits its use as a screening method. Plethysmography merits wider evaluation, since it is non-invasive, and sensitive to major thrombosis.Community epidemiology. Data on the community epidemiology are limited. The risk increases with age. When age is taken into account, there is little sex difference. Overweight in women, use of oral contraceptives and blood group A increase the risk: smoking, varicose veins, blood pressure, cholesterol and glucose do not, on current evidence. Long-term follow-up of patients with proven thromboembolism shows an increased risk of malignancy, hence occult cancer may also be a risk factor. Polycythaemia and certain congenital deficiencies (e.g. antithrombin III) are also well-recognised risk factors, although uncommon.Hospital epidemiology. Data on hospital epidemiology are derived largely from autopsy prevalence, and from short-term incidence of minimal thrombosis detected by 125I—fibrinogen scanning. Old, immobile and traumatised patients are most at risk. Previous thromboembolism, polycythaemia, antithrombin III deficiency, hip and leg fractures, elective hip and leg surgery, hemiplegia, paraplegia, and heart failure carry high risks, and merit consideration for routine prophylaxis. The risk in elective surgery precedes the operation, and increases with age, overweight, malignancy, varicose veins, non-smoking, and operative factors (duration, approach, general anaesthesia, intravenous fluids). Diabetics appear to have no extra risk. Combinations of clinical variables can be used to predict high risk groups for selective prophylaxis, but combination indices require further study. Laboratory variables may increase the predictability of deep vein thrombosis, but the results of published studies are conflicting, and the cost-effectiveness of laboratory prediction should be evaluated.
APA, Harvard, Vancouver, ISO, and other styles

Reports on the topic "Coronary heart disease – Treatment – Cost-effectiveness"

1

Treadwell, Jonathan R., James T. Reston, Benjamin Rouse, Joann Fontanarosa, Neha Patel, and Nikhil K. Mull. Automated-Entry Patient-Generated Health Data for Chronic Conditions: The Evidence on Health Outcomes. Agency for Healthcare Research and Quality (AHRQ), March 2021. http://dx.doi.org/10.23970/ahrqepctb38.

Full text
Abstract:
Background. Automated-entry consumer devices that collect and transmit patient-generated health data (PGHD) are being evaluated as potential tools to aid in the management of chronic diseases. The need exists to evaluate the evidence regarding consumer PGHD technologies, particularly for devices that have not gone through Food and Drug Administration evaluation. Purpose. To summarize the research related to automated-entry consumer health technologies that provide PGHD for the prevention or management of 11 chronic diseases. Methods. The project scope was determined through discussions with Key Informants. We searched MEDLINE and EMBASE (via EMBASE.com), In-Process MEDLINE and PubMed unique content (via PubMed.gov), and the Cochrane Database of Systematic Reviews for systematic reviews or controlled trials. We also searched ClinicalTrials.gov for ongoing studies. We assessed risk of bias and extracted data on health outcomes, surrogate outcomes, usability, sustainability, cost-effectiveness outcomes (quantifying the tradeoffs between health effects and cost), process outcomes, and other characteristics related to PGHD technologies. For isolated effects on health outcomes, we classified the results in one of four categories: (1) likely no effect, (2) unclear, (3) possible positive effect, or (4) likely positive effect. When we categorized the data as “unclear” based solely on health outcomes, we then examined and classified surrogate outcomes for that particular clinical condition. Findings. We identified 114 unique studies that met inclusion criteria. The largest number of studies addressed patients with hypertension (51 studies) and obesity (43 studies). Eighty-four trials used a single PGHD device, 23 used 2 PGHD devices, and the other 7 used 3 or more PGHD devices. Pedometers, blood pressure (BP) monitors, and scales were commonly used in the same studies. Overall, we found a “possible positive effect” of PGHD interventions on health outcomes for coronary artery disease, heart failure, and asthma. For obesity, we rated the health outcomes as unclear, and the surrogate outcomes (body mass index/weight) as likely no effect. For hypertension, we rated the health outcomes as unclear, and the surrogate outcomes (systolic BP/diastolic BP) as possible positive effect. For cardiac arrhythmias or conduction abnormalities we rated the health outcomes as unclear and the surrogate outcome (time to arrhythmia detection) as likely positive effect. The findings were “unclear” regarding PGHD interventions for diabetes prevention, sleep apnea, stroke, Parkinson’s disease, and chronic obstructive pulmonary disease. Most studies did not report harms related to PGHD interventions; the relatively few harms reported were minor and transient, with event rates usually comparable to harms in the control groups. Few studies reported cost-effectiveness analyses, and only for PGHD interventions for hypertension, coronary artery disease, and chronic obstructive pulmonary disease; the findings were variable across different chronic conditions and devices. Patient adherence to PGHD interventions was highly variable across studies, but patient acceptance/satisfaction and usability was generally fair to good. However, device engineers independently evaluated consumer wearable and handheld BP monitors and considered the user experience to be poor, while their assessment of smartphone-based electrocardiogram monitors found the user experience to be good. Student volunteers involved in device usability testing of the Weight Watchers Online app found it well-designed and relatively easy to use. Implications. Multiple randomized controlled trials (RCTs) have evaluated some PGHD technologies (e.g., pedometers, scales, BP monitors), particularly for obesity and hypertension, but health outcomes were generally underreported. We found evidence suggesting a possible positive effect of PGHD interventions on health outcomes for four chronic conditions. Lack of reporting of health outcomes and insufficient statistical power to assess these outcomes were the main reasons for “unclear” ratings. The majority of studies on PGHD technologies still focus on non-health-related outcomes. Future RCTs should focus on measurement of health outcomes. Furthermore, future RCTs should be designed to isolate the effect of the PGHD intervention from other components in a multicomponent intervention.
APA, Harvard, Vancouver, ISO, and other styles
You might also be interested in the extended bibliographies on the topic 'Coronary heart disease – Treatment – Cost-effectiveness' for particular source types:
Journal articles
We offer discounts on all premium plans for authors whose works are included in thematic literature selections. Contact us to get a unique promo code!

To the bibliography