Journal articles: '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

11

Korzh, O. M. "CURRENT ASPECTS OF CORONARY HEART DISEASE DIAGNOSIS AND TREATMENT." International Medical Journal, no. 1 (March 5, 2020): 5–10. http://dx.doi.org/10.37436/2308-5274-2020-1-1.

Full text

Abstract:

Among the cardiovascular diseases associated with atherosclerosis, chronic coronary heart disease, including angina, is the most common form. It is the myocardium lesion that develops as a result of an imbalance between the coronary circulation and metabolic needs of heart muscle. The presence of angina symptoms often indicates a pronounced narrowing of one or more coronary arteries, but also occurs in non−obstructive arterial impairment and even in normal coronary arteries. Factors of functional damage to the coronary arteries are spasm, temporary platelet aggregation and intravascular thrombosis. Today there are opportunities not only to use the therapy with proven effectiveness, aimed at reducing the risk of complications, including fatal, but also to treat angina (ischemia), which improves the patient's life quality. The drug protocol includes the ones with a proven positive effect on this disease prognosis, which are mandatory if there are no direct contraindications to use, as well as a large group of antianginal or anti−ischemic drugs. The choice of a particular drug or its combinations with other drugs is carried out in accordance with generally accepted recommendations: taking into account the individual approach, the severity of angina, hemodynamic parameters (heart rate and blood pressure, presence of comorbid conditions). If drug therapy is ineffective, the option of coronary myocardial revascularization (percutaneous coronary angioplasty or coronary artery bypass grafting) is considered. Due to the high mortality and morbidity rates of coronary heart disease worldwide, one of the priorities of practical health care is the prevention of diseases caused by atherosclerosis. Key words: coronary heart disease, angina, family physician, prognosis, drug therapy.

APA, Harvard, Vancouver, ISO, and other styles

12

Rofi'ah, Ika Ainur, and Eka Nur So'emah. "LITERATURE REVIEW: EFFECTIVENESS OF CARDIAC REHABILITATION IN PATIENTS WITH CORONARY HEART DISEASE." INTERNATIONAL JOURNAL OF NURSING AND MIDWIFERY SCIENCE (IJNMS) 4, no. 2 (August 29, 2020): 141–52. http://dx.doi.org/10.29082/ijnms/2020/vol4/iss2/296.

Full text

Abstract:

Background: Cardiac rehabilitation is an evidence-based intervention that includes physical exercise, health education, and modification of health behavior in patients with cardiovascular disease. Cardiac rehabilitation is considered as secondary prevention after acute coronary syndrome and improves treatment outcomes in patients with coronary heart disease. This literature review aimed to evaluate the effectiveness of cardiac rehabilitation in coronary heart disease patients. Methods: This present study was a literature review discussing cardiac rehabilitation for coronary heart disease patients. Results: The result showed that the functional capacity of the CR group was more increased compared to non-CR (p <0.001; α <0.05), left ventricular ejection fraction (LVEF) significantly increased in the CR group (p < 0.05; α <0.05), the medical cost of CR group was lower significantly (p=0.042; α <0.05), and the risk of recurrence rate was significantly lower in CR group (p=0.004; α <0.05). Conclusions: Cardiac rehabilitation is known to increase functional capacity, increase left ventricular ejection fraction (LVEF), reduce medical costs, and reduce the recurrence rate of patients with CHD.

APA, Harvard, Vancouver, ISO, and other styles

13

Bennett, Kathleen, Zubair Kabir, Michael Barry, Lesley Tilson, Dogan Fidan, Emer Shelley, and Simon Capewell. "Cost-Effectiveness of Treatments Reducing Coronary Heart Disease Mortality in Ireland, 2000 to 2010." Value in Health 12, no. 1 (January 2009): 10–15. http://dx.doi.org/10.1111/j.1524-4733.2008.00398.x.

Full text

APA, Harvard, Vancouver, ISO, and other styles

14

Gillespie, Paddy, Eamon O'Shea, Andrew W. Murphy, Mary C. Byrne, Molly Byrne, Susan M. Smith, and Margaret E. Cupples. "The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease." International Journal of Technology Assessment in Health Care 26, no. 3 (June 29, 2010): 263–71. http://dx.doi.org/10.1017/s0266462310000358.

Full text

Abstract:

Objectives: The Secondary Prevention of Heart disEase in geneRal practicE (SPHERE) trial has recently reported. This study examines the cost-effectiveness of the SPHERE intervention in both healthcare systems on the island of Ireland.Methods: Incremental cost-effectiveness analysis. A probabilistic model was developed to combine within-trial and beyond-trial impacts of treatment to estimate the lifetime costs and benefits of two secondary prevention strategies: Intervention - tailored practice and patient care plans; and Control - standardized usual care.Results: The intervention strategy resulted in mean cost savings per patient of €512.77 (95 percent confidence interval [CI], −1086.46–91.98) and an increase in mean quality-adjusted life-years (QALYs) per patient of 0.0051 (95 percent CI, −0.0101–0.0200), when compared with the control strategy. The probability of the intervention being cost-effective was 94 percent if decision makers are willing to pay €45,000 per additional QALY.Conclusions: Decision makers in both settings must determine whether the level of evidence presented is sufficient to justify the adoption of the SPHERE intervention in clinical practice.

APA, Harvard, Vancouver, ISO, and other styles

15

Pickin, D. M., C. J. McCabe, L. E. Ramsay, N. Payne, I. U. Haq, W. W. Yeo, and P. R. Jackson. "Cost effectiveness of HMG-CoA reductase inhibitor (statin) treatment related to the risk of coronary heart disease and cost of drug treatment." Heart 82, no. 3 (September 1, 1999): 325–32. http://dx.doi.org/10.1136/hrt.82.3.325.

Full text

APA, Harvard, Vancouver, ISO, and other styles

16

Rosen, Virginia M., Douglas C. A. Taylor, Hemangi Parekh, Ankur Pandya, David Thompson, Andreas Kuznik, David D. Waters, Michael Drummond, and Milton C. Weinstein. "Cost Effectiveness of Intensive Lipid-Lowering Treatment for Patients with Congestive Heart Failure and Coronary Heart Disease in the US." PharmacoEconomics 28, no. 1 (January 2010): 47–60. http://dx.doi.org/10.2165/11531440-000000000-00000.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Yeaton, William H., and Paul M. Wortman. "Medical Technology Assessment." International Journal of Technology Assessment in Health Care 1, no. 1 (January 1985): 125–46. http://dx.doi.org/10.1017/s0266462300003780.

Full text

Abstract:

Coronary artery bypass graft surgery (CABGS) has become an important procedure for the treatment of coronary heart disease. Over 100,000 of these surgical procedures are performed each year (1) at an aggregate cost of about $2 billion (2). Despite its current widespread acceptance, this major surgical innovation has generated considerable controversy concerning its effectiveness (3), and there still remains substantial confusion in assessing its overall impact (4).

APA, Harvard, Vancouver, ISO, and other styles

18

Kremneva, L. V., T. S. Pursanova, and O. V. Abaturova. "CARBOHYDRATE METABOLISM DISORDERS AND CORONARY HEART DISEASE: PROGNOSTIC VALUE AND REVASCULARISATION EFFECTIVENESS." Cardiovascular Therapy and Prevention 12, no. 3 (June 20, 2013): 79–84. http://dx.doi.org/10.15829/1728-8800-2013-3-79-84.

Full text

Abstract:

This literature review presents the data on the prevalence and prognostic value of carbohydrate metabolism disorders, such as Type 2 diabetes mellitus (DM) and pre-diabetes — fasting hyperglycaemia and impaired glucose tolerance), among patients with coronary heart disease (CHD). The authors present the results of large studies on comparative effectiveness of modern pharmacological treatment and myocardial revascularisation (percutaneous coronary intervention and coronary artery bypass graft surgery) in patients with CHD and DM.

APA, Harvard, Vancouver, ISO, and other styles

19

Mark, Daniel B. "Implications of cost in treatment selection for patients with coronary heart disease." Annals of Thoracic Surgery 61, no. 2 (February 1996): s12—s15. http://dx.doi.org/10.1016/0003-4975(95)01077-7.

Full text

APA, Harvard, Vancouver, ISO, and other styles

20

Leong, Darryl P., Philip G. Joseph, Martin McKee, Sonia S. Anand, Koon K. Teo, Jon-David Schwalm, and Salim Yusuf. "Reducing the Global Burden of Cardiovascular Disease, Part 2." Circulation Research 121, no. 6 (September 2017): 695–710. http://dx.doi.org/10.1161/circresaha.117.311849.

Full text

Abstract:

In this second part of a 2-part series on the global burden of cardiovascular disease, we review the proven, effective approaches to the prevention and treatment of cardiovascular disease. We specifically review the management of acute cardiovascular diseases, including acute coronary syndromes and stroke; the care of cardiovascular disease in the ambulatory setting, including medical strategies for vascular disease, atrial fibrillation, and heart failure; surgical strategies for arterial revascularization, rheumatic and other valvular heart disease, and symptomatic bradyarrhythmia; and approaches to the prevention of cardiovascular disease, including lifestyle factors, blood pressure control, cholesterol-lowering, antithrombotic therapy, and fixed-dose combination therapy. We also discuss cardiovascular disease prevention in diabetes mellitus; digital health interventions; the importance of socioeconomic status and universal health coverage. We review building capacity for conduction cardiovascular intervention through strengthening healthcare systems, priority setting, and the role of cost effectiveness.

APA, Harvard, Vancouver, ISO, and other styles

21

Mainie, Paula M., Gillian Moore, John W. Riddell, and A. A. Jennifer Adgey. "To Examine the Effectiveness of a Hospital-Based Nurse-Led Secondary Prevention Clinic." European Journal of Cardiovascular Nursing 4, no. 4 (December 2005): 308–13. http://dx.doi.org/10.1016/j.ejcnurse.2005.04.003.

Full text

Abstract:

Modification of cardiovascular risk factors can reduce the incidence of myocardial infarction (MI), effectively extend survival, decrease the need for interventional procedures, and improve quality of life in persons with known cardiovascular disease. Pharmacological treatments and important lifestyle changes reduce people's risks substantially (by 1/3 to 2/3) and can slow and perhaps reverse progression of established coronary disease. When used appropriately, these interventions are more cost-effective than many other treatments, currently provided by the National Health Service [Department of Health National Service Frameworks: coronary heart disease. Preventing coronary heart disease in high risk patients. 2000. HMSO.] Secondary prevention clinics are effective means by which to ensure targets are achieved and assist primary care in long-term maintenance of lifestyle change and drug optimisation. A 2-year hospital-based pilot project was established at the Royal Hospitals, April 2001–April 2003. The aim of the project was to target patients with coronary heart disease, post-MI and/or coronary artery bypass grafting and/or percutaneous coronary intervention, 6 months following their cardiac event. The plan was to assess patient risk factors and medication a minimum of 6 months following their cardiac event to ascertain if government targets were being achieved; secondly, to examine the effectiveness of a hospital-based nurse-led secondary prevention clinic on modifying risk factors and optimising drug therapies.

APA, Harvard, Vancouver, ISO, and other styles

22

Morris, Stephen, Alistair McGuire, Jaime Caro, and Daniel Pettitt. "Strategies for the Management of Hypercholesterolaemia: A Systematic Review of the Cost-Effectiveness Literature." Journal of Health Services Research & Policy 2, no. 4 (October 1997): 231–50. http://dx.doi.org/10.1177/135581969700200408.

Full text

Abstract:

Objective: To review research addressing the management of cholesterol in the prevention of coronary heart disease in order to assess the cost-effectiveness of such interventions. Methods: A systematic review of economic evaluations identified through searches of MEDLINE and the Social Sciences Citation Index revealed 38 studies addressing the cost-effectiveness of cholesterol management. They were distinguished according to screening approaches, dietary advice and drug treatment. Most studies were not associated directly with clinical trial results, but adopted economic modelling approaches. Results: Whilst there is general agreement among the majority of analyses, studies of cholesterol management concerned with screening strategies were extremely sensitive to changes in their assumptions; so much so that only a limited emphasis may be placed on specific cost-effectiveness ratios and the conclusions drawn from them. All studies considered direct costs, though many were limited to drug costs. The cost-effectiveness of primary prevention by cholesterol-lowering drugs is highly variable, depending on age at initiation of treatment and cardiovascular risk profile. Pharmacological intervention is least cost-effective in the young and the elderly. The cost-effectiveness of cholesterol-reducing agents improves when they are targeted at those at high risk. HMG-CoA reductase inhibitors are generally more effective and more cost-effective at reducing cholesterol-related coronary events than other medications. Conclusion: The methods and economic data upon which these studies are based need to be improved if robust policy conclusions are to be formulated.

APA, Harvard, Vancouver, ISO, and other styles

23

Kim, Hansol, Jin Kook Kim, and Jae Hoon Cho. "Cost-Effectiveness Analysis of Positive Airway Pressure in Patient with Obstructive Sleep Apnea." Journal of Rhinology 28, no. 2 (July 31, 2021): 94–101. http://dx.doi.org/10.18787/jr.2021.00357.

Full text

Abstract:

Background and Objectives: Positive airway pressure (PAP) is effective at reducing the number of complications in patients with obstructive sleep apnea (OSA). To the best of our knowledge, no cost-effectiveness analysis of PAP has been conducted in Korea. Subjects and Method: We classified subjects into two groups, those with moderate-to-severe OSA who used PAP after polysomnography (PAP treatment group) and those who did not receive a diagnosis and treatment (control group), and compared their medical expenses over a period of 10 years. The incidence rate of common complications and accidents (coronary heart disease, heart failure, stroke, depression, diabetes, vehicular accidents, and work-related accidents) with or without PAP was adopted through a literature review. The average medical expenses for treating each complication and accident were found by searching several databases. The analysis consisted of a payer’s perspective and a societal perspective. Results: The incidence of all complications was higher in the control group than in the PAP treatment group. However, since the absolute incidence rate was not high in either group and medical expenses in Korea are low, the expected treatment cost was not high. In contrast, the PAP rental fee was relatively high. To obtain 1 unit of disability-adjusted life year, it costs 40,873,288 won from the payer’s perspective and 31,791,810 won from the societal perspective. Conclusion: PAP treatment reduces patient complications and extends their lifespan, but costs must be considered.

APA, Harvard, Vancouver, ISO, and other styles

24

Westwood, M., M. Al, L. Burgers, K. Redekop, S. Lhachimi, N. Armstrong, H. Raatz, K. Misso, J. Severens, and J. Kleijnen. "A systematic review and economic evaluation of new-generation computed tomography scanners for imaging in coronary artery disease and congenital heart disease: Somatom Definition Flash, Aquilion ONE, Brilliance iCT and Discovery CT750 HD." Health Technology Assessment 17, no. 9 (March 2013): 1–243. http://dx.doi.org/10.3310/hta17090.

Full text

Abstract:

BackgroundComputed tomography (CT) is important in diagnosing and managing many conditions, including coronary artery disease (CAD) and congenital heart disease. Current CT scanners can very accurately diagnose CAD requiring revascularisation in most patients. However, imaging technologies have developed rapidly and new-generation computed tomography (NGCCT) scanners may benefit patients who are difficult to image (e.g. obese patients, patients with high or irregular heart beats and patients who have high levels of coronary calcium or a previous stent or bypass graft).ObjectiveTo assess the clinical effectiveness and cost-effectiveness of NGCCT for diagnosing clinically significant CAD in patients who are difficult to image using 64-slice computed tomography and treatment planning in complex congenital heart disease.Data sourcesBibliographic databases were searched from 2000 to February/March 2011, including MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects (DARE), NHS Economic Evaluation Database (NHS EED), Health Technology Assessment (HTA) database and Science Citation Index (SCI). Trial registers and conference proceedings were searched.Review methodsSystematic review methods followed published guidance. Risk of bias was assessed using QUADAS-2. Results were stratified by patient group. Summary sensitivity and specificity were calculated using a bivariate summary receiver operating characteristic, or random effects model. Heterogeneity was assessed using the chi-squared statistic andI2-statistic. Cost-effectiveness of NGCCT was modelled separately for suspected and known CAD, evaluating invasive coronary angiography (ICA) only, ICA after positive NGCCT (NGCCT–ICA), and NGCCT only. The cost-effectiveness of NGCCT, compared with 64-slice CT, in reducing imaging-associated radiation in congenital heart disease was assessed.ResultsTwenty-four studies reported accuracy of NGCCT for diagnosing CAD in difficult-to-image patients. No clinical effectiveness studies of NGCCT in congenital heart disease were identified. The pooled per-patient estimates of sensitivity were 97.7% [95% confidence interval (CI) 88.0% to 99.9%], 97.7% (95% CI 93.2% to 99.3%) and 96.0% (95% CI 88.8% to 99.2%) for patients with arrhythmias, high heart rates and previous stent, respectively. The corresponding estimates of specificity were 81.7% (95% CI 71.6% to 89.4%), 86.3% (95% CI 80.2% to 90.7%) and 81.6% (95% CI 74.7% to 87.3%), respectively. In patients with high coronary calcium scores, previous bypass grafts or obesity, only per-segment or per-artery data were available. Sensitivity estimates remained high (> 90% in all but one study). In patients with suspected CAD, the NGCCT-only strategy appeared most cost-effective; the incremental cost-effectiveness ratio (ICER) of NGCCT–ICA compared with NGCCT only was £71,000. In patients with known CAD, the most cost-effective strategy was NGCCT–ICA (highest cost saving, dominates ICA only). The ICER of NGCCT only compared with NGCCT–ICA was £726,230. For radiation exposure only, the ICER for NGCCT compared with 64-slice CT in congenital heart disease ranged from £521,000 for the youngest patients to £90,000 for adults.LimitationsAvailable data were limited, particularly for obese patients and patients with previous bypass grafts. All studies of the accuracy of NGCCT assume that the reference standard (ICA) is 100% sensitive and specific; however, there is some evidence that ICA may sometimes underestimate the extent and severity of stenosis. Patients with more than one criterion that could contribute to difficulty in imaging were often excluded from studies; the effect on test accuracy of multiple difficult to image criteria remains uncertain.ConclusionsNGCCT may be sufficiently accurate to diagnose clinically significant CAD in some or all difficult-to-image patient groups. Economic analyses suggest that NGCCT is likely to be considered cost-effective for difficult-to-image patients with CAD, at current levels of willingness to pay in the NHS. For patients with suspected CAD, NGCCT only would be most favourable; for patients with known CAD, NGCCT–ICA would be most favourable. No studies assessing the effects of NGCCT on therapeutic decision making, or subsequent patient outcomes, were identified. The ideal study to address these questions would be a large multi-centre RCT. However, one possible alternative might be to establish a multicentre tracker study. High-quality test accuracy studies, particularly in obese patients, patients with high coronary calcium, and those with previous bypass grafts are needed to confirm the findings of our systematic review. These studies should include patients with multiple difficult to image criteria.FundingThe National Institute for Health Research Health Technology Assessment programme. This project was funded by the HTA programme, on behalf of NICE, as project number 10/107/01.

APA, Harvard, Vancouver, ISO, and other styles

25

Fendrikova, A. V., and V. V. Skibitskyi. "Effectiveness of the original trimetazidine MR in patients with stable coronary heart disease and angina attacks resistant to trimetazidine generics (ETALON study)." Cardiovascular Therapy and Prevention 10, no. 4 (August 20, 2011): 96–100. http://dx.doi.org/10.15829/1728-8800-2011-4-96-100.

Full text

Abstract:

Aim. To assess the clinical benefits of the original trimetazidine medication (Preductal® MR) in patients with stable coronary heart disease and angina attacks resistant to trimetazidine generics. Material and methods. The study included 112 patients with stable coronary heart disease (CHD), who experienced angina attacks, despite the treatment with trimetazidine generics added to the standard CHD therapy (antiaggregants, statins, β-аadrenoblockers, ACE inhibitors). All participants received Preductal® MR (35 mg twice a day) instead of trimetazidine generics. The follow-up duration was 3 months. Treatment effectiveness was assessed by the changes in angina attack incidence, short-acting nitrate consumption, and general status, using a visual analogue scale (VAS). In addition, pharmaco-economic analysis of the treatment effectiveness was performed. Results. The replacement of trimetazidine generics with Preductal® MR was associated with a reduction in angina attack incidence by 63 % and in the number of nitroglycerine tablets/doses by 65 % (p<0,01). VAS score increased from 45,3±13,8 to 71,6±11,9 (р<0,0001). Preductal® MR therapy is the best pharmaco-economic option, since the ratio between weekly treatment costs (RUB) and the weekly number of prevented angina attacks is minimal for this original medication. Conclusion. In patients with stable CHD and angina attacks, resistant to trimetazidine generics, Preductal® МR therapy is associated with a significant reduction in angina attack incidence and consumption of short-acting nitrates. Preductal® MR is the most cost-effective medication, providing optimal effectiveness with minimal costs.

APA, Harvard, Vancouver, ISO, and other styles

26

Pizga, Aspasia, Panagiotis Kordoutis, Stamatoula Tsikrika, Ioannis Vasileiadis, Serafeim Nanas, and Eleftherios Karatzanos. "Effects of cognitive behavioral therapy on depression, anxiety, sleep and quality of life for patients with heart failure and coronary heart disease. a systematic review of clinical trials 2010 – 2020." Health & Research Journal 7, no. 3 (July 6, 2021): 123. http://dx.doi.org/10.12681/healthresj.27572.

Full text

Abstract:

Background: There is a growning evidence that CBT (Cognitive Behavioral Therapy) improves mental health of patients with chronic illnesses but its effectiveness is not well established in patients with heart diseases. The present systematic review was conducted to evaluate the effects of CBT in heart failure (HF) and coronary heart disease (CHD) patients.Methods: Pubmed, Cohraine and Google Scholar were searched for studies with randomized controlled trials. Studies were required to assess the effectiveness of CBT in depression, anxiety, sleep and quality of life of patients suffering from heart failure and coronary heart disease. SStudies identified were independently screened by two reviewers and critically appraised using the PedroScale.Results: Sixteen randomized controlled trials were included in the review. The majority of the studies indicated that CBT therapy was effective treatment for reducing depression and anxiety and can also be beneficial for sleeping disorders and improve quality of life of patients with heart failure and coronary heart disease. Althought face to face CBT therapy seems to be clinicaly effective, internet-based CBT therapy was not superior to a guided web-based discussion forum.Conclusions: CBT can improve psychological health and quality of life of cardiac patients and further enhance benefits of rehabilitation programs. Findings suggest that face-to-face CBT is superior to usual care and it can be incorporated in cardiac rehabilitations programs. Future studies are needed to identify the effectiveness of internet-based CBT on cardiac patients and address the factors that will increase treatment adherence.

APA, Harvard, Vancouver, ISO, and other styles

27

Popova, A. Yu, L. V. Kondrat'eva, and A. S. Ametov. "Phosphodiesterase type 5 inhibitor (Levitra): possibility of correction of erectile dysfunction in obese patients." Obesity and metabolism 5, no. 1 (March 15, 2008): 24–29. http://dx.doi.org/10.14341/omet2008124-29.

Full text

Abstract:

Obesity is the cause of a number of diseases such as type 2 diabetes, hypertension, atherosclerosis and coronary heart disease [1]. Obesity is associated with the development of a number of hormone-dependent tumors (breast cancer, uterine cancer) and colon cancer [2]. Metabolic and hormonal disorders that accompany obesity and underlying a number of diseases, including may have an impact on erectile function. Despite the fact that in the literature there are few publications on the relationship of obesity and erectile dysfunction (ED), we could not find work on the effectiveness of treatment of patients with erectile dysfunction and obesity. These large-scale research on the role of weight loss in the treatment of other diseases, such as such as type 2 diabetes, hypertension, coronary heart disease, suggest that weight control and related metabolic disorders are able to provide a significant improvement in erectile quality function and effectiveness of the treatment of ED [3, 4, 5, 6].

APA, Harvard, Vancouver, ISO, and other styles

28

Khandelwal, Samridhi, Vandana Sharma, Ramesh Pareek, Shailendra Tripathi, Shankar Soni, and Pawan Upadhyay. "PROSPECTIVE ANALYSIS OF IMPACT OF PHARMCOTHERAPY ADHERENCE ON TREATMENT EFFECTIVENESS IN POST OPERATIVE HEART PATIENTS." Journal of Biomedical and Pharmaceutical Research 10, no. 1 (February 16, 2021): 40–51. http://dx.doi.org/10.32553/jbpr.v10i1.836.

Full text

Abstract:

Myocardial infarction is the irreversible damage of myocardial tissue caused by prolonged ischemia and hypoxia. This most commonly occurs when a coronary artery becomese blocked following the rupture of an atherosclerotic plaque, which then leads to the formation of a blood clot (coronary thrombosis). This event can also trigger coronary vasospasm. Ischemia induces profound metabolic and ionic perturbations in the affected myocardium and causes rapid depression of systolic function. Prolonged myocardial ischemia activates a "wavefront" of cardiomyocyte death that extends from the subendocardium to the subepicardium. Mitochondrial alterations are prominently involved in apoptosis and necrosis of cardiomyocytes in the infarcted heart. This prospective, pilot, observational study performed confirmed the hypothesis that systematic identifications and interventions administered through continued physician follow-up and patients counselling will improve adherence to therapy and therefore improvement in treatment effectiveness by lowering especially Troponin level ,CPK and quality of life in MI patients. Study was shown that lack of proper knowledge about disease and patients counseling and chronic treatment, most of patients takes disease and its treatment lightly and shows lower adherence attitude. The study analysis shown that female are generally more aware than males for adherence. Study analysis concluded that there was significant reduction in their Troponin level and CPK values in different comparison groups after each level of follow up. Statistical analysis concluded that patients with adherence ˃ 95% showed significant reduction in Troponin level and CPK values and patients with age group ≤50 shows more adherence than older. Most heart patients recorded with hypertension and Coronary Artery Diseases only few ones with diabetic complications. During study patients shows good control over their blood pressure and only few adverse events but no complications occur during study period.

APA, Harvard, Vancouver, ISO, and other styles

29

Lutai, M. I., and I. P. Golikova. "The effectiveness of treatment of patients with stable coronary heart disease and concomitant arterial hypertension: the results of a multicenter study PRESTOL." Ukrainian Journal of Cardiology 26, no. 1 (April 16, 2019): 19–30. http://dx.doi.org/10.31928/1608-635x-2019.1.1930.

Full text

Abstract:

The aim – to evaluate the profile of patients with coronary heart disease (CHD) and concomitant arterial hypertension (AH) who were administered bisoprolol as part of previous therapy, but did not reach normal levels of heart rate and blood pressure; to estimate the percentage of getting to recommended levels of heart rate, blood pressure and treatment adherence in patients after 4 weeks of using the fixed-dose combination of bisoprolol/perindopril with a correction of doses. Materials and methods. The study involved 170 cardiologists from various regions of Ukraine. Each researcher selected 15 consecutive outpatients with coronary heart disease who came for a regular visit. Inclusion criteria: age over 18 years old, blood pressure above 140/90 mm Hg, heart rate above 60 bpm, bisoprolol as part of antihypertensive therapy in the last ≥ 3 months. The study included two visits. At each visit, the patient’s objective status was assessed; an individual questionnaire with office systolic and diastolic blood pressure, heart rate, ECG data, clinical manifestations of CHD, risk factors, lifestyle features, concomitant diseases, current therapy was filled out. Medication adherence was also evaluated, the therapy was corrected if necessary and the presence of side effects and adverse events was registered. Results and discussion. 2785 patient questionnaires were provided by doctors, 2394 (86 %) of them met the inclusion criteria. The mean age of the patients was 61.4 years, men – 57.1 %, women – 42.9 %. The diagnosis of coronary artery disease was based on: chest pain – 751 (31.7 %), a history of documented myocardial infarction – 1281 (53.5 %), coronary ventriculography (VHR) – 735 (30.7 %), revascularization (CABG/stenting) – 474 (19.8 %) patients. The use of a fixed combination of previously taken drugs (perindopril, bisoprolol) for 4 weeks allows to reduce heart rate and blood pressure effectively (heart rate ≤ 70 bpm reached 84.9 % of patients, blood pressure ≤ 140/90 mm Hg – 86.9 %), to reduce the number of angina attacks from 4.4 to 2.6 per week and the need for nitroglycerin from 4.8 to 2.7 tablets per week, to improve therapy adherence in 66.5 % of patients. Conclusions. The study demonstrated that the use of the fixed combination of bisoprolol and perindopril in patients with coronary artery disease and concomitant hypertension, including those who had myocardial revascularization and myocardial infarction in anamnesis, helps to improve treatment efficacy, to achieve recommended levels of blood pressure and heart rate, to increase adherence to therapy.

APA, Harvard, Vancouver, ISO, and other styles

30

Golukhova, E. Z., A. A. Kupryashov, G. A. Khicheva, E. V. Kuksina, O. I. Volkova, E. O. Kurilovich, and L. D. Popovich. "Socio-economic assessment of patient blood management practical implementation in surgical treatment of coronary heart disease (I20–I25)." Kardiologiia 61, no. 3 (March 30, 2021): 77–86. http://dx.doi.org/10.18087/cardio.2021.3.n1557.

Full text

Abstract:

Aim To evaluate possible social and economic benefits of correcting preoperative iron deficiency /iron deficiency anemia as a comorbidity in a model population in the process of transition from the routine practice to the optimized preparation of patients to elective surgery (as exemplified by several circulatory diseases: I20 – I25, class IX ICD 10).Material and methods By building imitation models depending on the patient blood management (PBM) practice, changes in years of life lost/saved adjusted for disability were evaluated, including in monetary terms, in relation to the annual number of operations performed for ischemic heart disease (IHD) (I20 – I25) in the age group of 17 years and older, as well as a potential effect of PBM on the applied health economics.Results With implementation of the PBM systemic measures in cardiac surgery, the potentially prevented annual social and economic damage will amount to more than 38 thousand years of life saved and more than 20.2 billion rubles in monetary terms. Furthermore, it will be possible to exclude 9435 hemotransfusion from the cardiosurgical practice, which will annually save more than 2.3 thousand liters of blood with a total cost of 77.7 million rubles in favor of clinical situations that have no alternative.Conclusion The implementation of PBM in cardiac surgery, the discipline with the highest levels of preoperative iron deficiency/anemia and the use of blood components, will not only improve the clinical outcomes and cost-effectiveness of surgical interventions, but will also prevent social and economic damage to the country.

APA, Harvard, Vancouver, ISO, and other styles

31

Wang, M., A. E. Moran, J. Liu, P. G. Coxson, P. A. Heidenreich, D. Gu, J. He, L. Goldman, and D. Zhao. "Cost-Effectiveness of Optimal Use of Acute Myocardial Infarction Treatments and Impact on Coronary Heart Disease Mortality in China." Circulation: Cardiovascular Quality and Outcomes 7, no. 1 (January 1, 2014): 78–85. http://dx.doi.org/10.1161/circoutcomes.113.000674.

Full text

APA, Harvard, Vancouver, ISO, and other styles

32

Trukhan, D. I., A. L. Mazurov, and E. L. Davydov. "MYOCARDIAL CYTOPROTECTOR TRIMETAZIDINE MB-PREPARAT, INCREASES THE EFFECTIVENESS OF TREATMENT OF CHRONIC HEART FAILURE AND CORONARY HEART DISEASE." Medical Council, no. 7 (December 30, 2017): 75–83. http://dx.doi.org/10.21518/2079-701x-2017-7-75-83.

Full text

Abstract:

The results of numerous foreign and russian researches indicate that administration of trimetazidine MB, including its russian generic drug Deprenorm® MV, in the treatment of patients with ischemic heart disease, including those with concomitant chronic heart failure, is a real opportunity to improve the effectiveness of treatment of such patients.

APA, Harvard, Vancouver, ISO, and other styles

33

Иванов, D. Ivanov, Корниенко, and E. Kornienko. "Analgesia in the Treatment of Acute Coronary Syndrome (Litterature Review)." Journal of New Medical Technologies 21, no. 3 (September 5, 2014): 173–80. http://dx.doi.org/10.12737/5930.

Full text

Abstract:

Coronary arteries disease and its complications are the most frequent causes of death among people all over the world. Spasm and thrombosis of the coronary arteries are the main pathogeous causes of severe complications. The present review is devoted to the actual problem of increasing the effectiveness of conservative treatment of patients with ischemic heart disease by means of various methods of anesthesia. Modern concepts of the pathophysiology of coronary arteries disease, in particular, mechanism of pain, presented in the current views on the state of analgesia in cardiology, are described. The authors made analysis available today drugs used in the treatment of acute coronary syndrome and myocardial infarction. The action mechanisms of drugs from the point of view of clinical pathophysiology are presented. The authors identified advantages and side-effects of several drugs groups. The possibilities of using thoracic epidural anesthesia for care coronary heart disease, the mechanism of action of epidural anesthesia, clinical features, its anti-ischemic effect on the myocardium, the effect on the hemodynamics are described in details. Possible side effects and complications that the doctors encountered in medical practice and ways of their correction are described. In conclusion, the authors emphasize the perspective of wide practical use of epidural analgesia using local anesthetics and narcotic analgesics in cardiac patients.

APA, Harvard, Vancouver, ISO, and other styles

34

Trukhan, D. I., A. L. Mazurov, and E. L. Davydov. "MYOCARDIAL CYTOPROTECTOR TRIMETAZIDINE MB-PREPARAT, INCREASES THE EFFECTIVENESS OF TREATMENT OF CHRONIC HEART FAILURE AND CORONARY HEART DISEASE." Medical Council, no. 7 (December 30, 2017): 75–83. http://dx.doi.org/10.21518/2079-701x-2017-4-75-83.

Full text

APA, Harvard, Vancouver, ISO, and other styles

35

Wyse, Richard K. H. "Book Review: Cost-effective diagnosis and treatment of coronary heart disease. Topics in cardiac cardiology." Perfusion 13, no. 3 (May 1998): 217. http://dx.doi.org/10.1177/026765919801300311.

Full text

APA, Harvard, Vancouver, ISO, and other styles

36

Camacho, Elizabeth M., Linda M. Davies, Mark Hann, Nicola Small, Peter Bower, Carolyn Chew-Graham, Clare Baguely, et al. "Long-term clinical and cost-effectiveness of collaborative care (versus usual care) for people with mental–physical multimorbidity: cluster-randomised trial." British Journal of Psychiatry 213, no. 2 (May 15, 2018): 456–63. http://dx.doi.org/10.1192/bjp.2018.70.

Full text

Abstract:

BackgroundCollaborative care can support the treatment of depression in people with long-term conditions, but long-term benefits and costs are unknown.AimsTo explore the long-term (24-month) effectiveness and cost-effectiveness of collaborative care in people with mental-physical multimorbidity.MethodA cluster randomised trial compared collaborative care (integrated physical and mental healthcare) with usual care for depression alongside diabetes and/or coronary heart disease. Depression symptoms were measured by the symptom checklist-depression scale (SCL-D13). The economic evaluation was from the perspective of the English National Health Service.Results191 participants were allocated to collaborative care and 196 to usual care. At 24 months, the mean SCL-D13 score was 0.27 (95% CI, −0.48 to −0.06) lower in the collaborative care group alongside a gain of 0.14 (95% CI, 0.06-0.21) quality-adjusted life-years (QALYs). The cost per QALY gained was £13 069.ConclusionsIn the long term, collaborative care reduces depression and is potentially cost-effective at internationally accepted willingness-to-pay thresholds.Declaration of interestNone.

APA, Harvard, Vancouver, ISO, and other styles

37

Marushchak, Mariya, and Inna Krynytska. "PHARMACOLOGICAL TREATMENT OF OSTEOPOROSIS IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY CHRONIC HEART FAILURE." Asian Journal of Pharmaceutical and Clinical Research 12, no. 1 (January 7, 2019): 443. http://dx.doi.org/10.22159/ajpcr.2018.v12i1.29293.

Full text

Abstract:

Objective: Chronic heart failure (CHF) is a chronic multisystem disorder associated with a myriad of metabolic disturbances. Moreover, CHF may adversely affect bone metabolism and induce a severe bone loss, increasing susceptibility to fractures and osteoporosis. This study investigates the effect of combined calcium with Vitamin D3 supplement called “calcemin advance” and calcitonin in the prophylaxis and treatment of osteopenia and osteoporosis in patients with coronary heart disease (CHD) complicated by CHF with the establishment of their influence on the bone mineral density (BMD).Methods: A total of 59 patients with CHD complicated by CHF. Interventions: The physical examination findings, dual-energy X-ray absorptiometry findings, and treatment results were assessed.Results: The results of the calcemin advance usage in patients with osteopenic changes showed a positive dynamics of the studied parameters, both in the lumbar spine and in the femoral bone. In patients with osteoporosis, the usage of osteoprotective therapy (calcemin advance+miacalcic) contributed to the increasing of BMD in the lumbar spine and in the femoral bone versus patients who received only combined calcium with Vitamin D3 supplement.Conclusions: Our results suggest that bone density screening could be recommended in patients with prevalent CHF. Moreover, the results of our investigation substantiate the necessity and effectiveness of osteoprotective therapy in patients with CHF with osteoporosis by calcitonin (Miacalcic), in combination with combined calcium and Vitamin D3 supplement (calcemin advance), and by only calcemin advance - in patients with CHF and osteopenia.

APA, Harvard, Vancouver, ISO, and other styles

38

Marushchak, Mariya, and Inna Krynytska. "PHARMACOLOGICAL TREATMENT OF OSTEOPOROSIS IN PATIENTS WITH CORONARY HEART DISEASE COMPLICATED BY CHRONIC HEART FAILURE." Asian Journal of Pharmaceutical and Clinical Research 12, no. 1 (January 7, 2019): 443. http://dx.doi.org/10.22159/ajpcr.2019.v12i1.29293.

Full text

Abstract:

Objective: Chronic heart failure (CHF) is a chronic multisystem disorder associated with a myriad of metabolic disturbances. Moreover, CHF may adversely affect bone metabolism and induce a severe bone loss, increasing susceptibility to fractures and osteoporosis. This study investigates the effect of combined calcium with Vitamin D3 supplement called “calcemin advance” and calcitonin in the prophylaxis and treatment of osteopenia and osteoporosis in patients with coronary heart disease (CHD) complicated by CHF with the establishment of their influence on the bone mineral density (BMD).Methods: A total of 59 patients with CHD complicated by CHF. Interventions: The physical examination findings, dual-energy X-ray absorptiometry findings, and treatment results were assessed.Results: The results of the calcemin advance usage in patients with osteopenic changes showed a positive dynamics of the studied parameters, both in the lumbar spine and in the femoral bone. In patients with osteoporosis, the usage of osteoprotective therapy (calcemin advance+miacalcic) contributed to the increasing of BMD in the lumbar spine and in the femoral bone versus patients who received only combined calcium with Vitamin D3 supplement.Conclusions: Our results suggest that bone density screening could be recommended in patients with prevalent CHF. Moreover, the results of our investigation substantiate the necessity and effectiveness of osteoprotective therapy in patients with CHF with osteoporosis by calcitonin (Miacalcic), in combination with combined calcium and Vitamin D3 supplement (calcemin advance), and by only calcemin advance - in patients with CHF and osteopenia.

APA, Harvard, Vancouver, ISO, and other styles

39

Plans-Rubió, Pedro. "Cost-Effectiveness Analysis of Treatments to Reduce Cholesterol Levels, Blood Pressure and Smoking for the Prevention of Coronary Heart Disease." PharmacoEconomics 13, no. 5 (May 1998): 623–43. http://dx.doi.org/10.2165/00019053-199813050-00014.

Full text

APA, Harvard, Vancouver, ISO, and other styles

40

McKennee, J. M., C. M. Kurtyka, and C. F. Kirkwood. "Cost-effectiveness of low dose lovastatin and colestipol, alone and in combination, for the treatment of hypercholesterolemia in patients with coronary heart disease." Atherosclerosis 115 (June 1995): S27. http://dx.doi.org/10.1016/0021-9150(95)96360-5.

Full text

APA, Harvard, Vancouver, ISO, and other styles

41

Banu, Fatema Akhter, BH Nazma Yasmeen, Shahriar Parvez, and SK Akbar Hossain. "Coping ways of the medical cost in Ischemic Heart Disease patients of Bangladesh." Northern International Medical College Journal 9, no. 1 (March 12, 2018): 258–60. http://dx.doi.org/10.3329/nimcj.v9i1.35923.

Full text

Abstract:

Background : Ischemic Heart Disease (IHD) requires long term treatment which poses huge financial burden.It is very difficult for the patients of developing countries to maintain the treatment costs of IHD.Objectives : To estimate the medical treatment cost and to find out the coping ways of that in Ischemic Heart Disease patients.Methods: A descriptive type of cross sectional study was done during January 2014 to December 2014 at medical out-patient department of National Institute of Cardiovascular Disease (NICVD), Dhaka. Data were collected by using a pre-tested, semi-structured Questionnaire. Medical cost was calculated by drug cost, consultation cost, laboratory investigation cost, surgical cost, hospital cost and food cost. Data analysis was performed by using SPSS software version 20.Results : Out of 201 patients, majority (64.7%) were in the age group of 40-59 years. Most (92.54%)of them were male. Majority (56.2%) of the respondents had monthly family income of Tk. 10001-20000. Among all patients 43.8%spent total medical cost was with a range from Tk.50001-180000. 85.71%, 81.8%, 69.9% and 66.71% had coped with families by life style change whose monthly Tk. 20001-50000,Tk. 50001-100000, Tk. 10001-20000, Tk. 5000-10000 respectively. Coping ways in family by compromising treatment cost of other family members was minimum 0.0% within the income group Tk.5000-10000, which was statistically significant (p<0.05).Conclusion : The study concluded that the largest component of medical cost of IHD was the surgical cost which includes coronary angiogram, PTCA and bypass surgery. The patient compensate the burden of medical treatment cost of IHD from family savings, personal income, selling of property, personal loan, donation, health insurance and by Life style change, Reduction of food cost,and reducing social contact.Northern International Medical College Journal Vol.9(1) July 2017: 258-260

APA, Harvard, Vancouver, ISO, and other styles

42

Qiu, Yu, Hao Xu, and Dazhuo Shi. "Traditional Chinese Herbal Products for Coronary Heart Disease: An Overview of Cochrane Reviews." Evidence-Based Complementary and Alternative Medicine 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/417387.

Full text

Abstract:

Objective. The aim of this overview was to evaluate and summarize Cochrane reviews of traditional Chinese herbal products (TCHPs) as the treatment for coronary heart disease (CHD).Methods. We searched the Cochrane Database that was concerned with the effectiveness of TCHPs for CHD. We also searched the Cochrane Central Register of Controlled Trials. Reviews and primary studies of TCHP as the treatment of any type of CHD were included. Data were extracted according to predefined inclusion criteria by two independent reviewers.Results. Six Cochrane reviews were included. They related to a wide range of TCHPs for different types of CHD. Four reviews were concerned with angina pectoris (unstable or stable), one review was concerned with heart failure, and for acute myocardial infarction. No reviews concluded that TCHPs were definitely effective for CHD because of the weak evidence. Eight primary studies were TCHPs from CHD. These studies also maybe result in bias, but better than before.Conclusion. Several Cochrane reviews of TCHPs for the treatment of different types of CHD have recently been published. None of these reviews got definite conclusion favoring the effectiveness of TCHPs due to the weak evidence. With the improved quality of the new registered RCTs. The potential role of TCHPs in treating CHD is anticipated to be detected.

APA, Harvard, Vancouver, ISO, and other styles

43

Müller, Christian. "The Potential of Cardiac Markers to Improve Patient Management." Journal of Medical Biochemistry 27, no. 2 (January 1, 2008): 109–13. http://dx.doi.org/10.2478/v10011-008-0001-8.

Full text

Abstract:

The Potential of Cardiac Markers to Improve Patient ManagementB-type natriuretic peptide (BNP) is a quantitative marker for heart failure. The use of BNP in patients with dyspnea has consistently shown to improve patient management and reduce treatment cost. Additional indications with the potential to improve patient management include treatment monitoring in acute and chronic heart failure, pulmonary embolism, and coronary artery disease.

APA, Harvard, Vancouver, ISO, and other styles

44

Holdovskyy, B. M., I. V. Filimonova,, S. O. Potalov, K. V. Serikov, D. V. Lelyuk, and R. V. Filimonov. "Modern strategies for the treatment of psychoemotional stress in patients with heart coronary disease after myocardial revascularization." Modern medical technologies 40, no. 1 (February 19, 2019): 25–30. http://dx.doi.org/10.34287/mmt.1(40).2019.4.

Full text

Abstract:

Coronary heart disease in many countries of the world, including in Ukraine, causes high rates of morbidity, disability and mortality. The study of factors affecting the occurrence, course, prognosis and effectiveness of drug therapy for coronary artery disease is important and relevant. One of such factors is the psychological disorders of the anxiety-depressive spectrum, which often occur in patients with myocardial infarction and after coronary artery bypass grafting; therefore, such patients should be carefully examined for affective disorders and receive appropriate drug therapy.Purpose of the study. Improvement of diagnosis and optimization of patients treatment with ischemic heart disease with concomitant anxiety-depressive disorders after myocardial revascularization.Material and methods. The results of the study are based on survey data and dynamic observation of 95 patients with coronary heart disease, postinfarction cardiosclerosis after myocardial revascularization. The patients underwent examination during the initial examination and after 12 weeks.Results of the study and their discussion.In the study of the psychoemotional state in the patients examined after the treatment, a significant decrease in anxiety manifestations was revealed by 36,4% against the group without fluvoxamine, where there was no significant difference before and after treatment. The manifestations of depressive disorder in the fluvoxamine group significantly decreased after treatment by 45,8 (HADS) and by 47,0% (Beck), in contrast to the group without fluvoxamine, where there was no significant difference before and after treatment.Conclusions. Thus, it has been proved that with the addition of fluvoxamine to combined therapy for patients with ischemic heart disease, postinfarction cardiosclerosis after revascularization of the myocardium shows a more pronounced decrease in the manifestations of anxiety-depressive disorder. Keywords:anxiety-depressive disorders, ischemic heart disease, revascularization of myocardium, antidepressants.

APA, Harvard, Vancouver, ISO, and other styles

45

Didigova, R., Z. Ugurchieva, M. Imagozeva, A. Inarokova, A. Kontsevaya, and M. Mamedov. "PREVALENCE OF HYPERTENSION AND EFFECTIVENESS OF ITS TREATMENT IN CORONARY HEART DISEASE PATIENTS OF NORTH CAUCASUS." Journal of Hypertension 29 (June 2011): e540-e541. http://dx.doi.org/10.1097/00004872-201106001-01642.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Gryskiewicz, Kristen A., Craig I. Coleman, Effie L. Gillespie, and C. Michael White. "Cost-Effectiveness Analysis of Combination Statin/Ezetimibe Therapy for the Treatment of Elevated Low-Density Lipoprotein Cholesterol." Hospital Pharmacy 40, no. 8 (August 2005): 687–92. http://dx.doi.org/10.1177/001857870504000808.

Full text

Abstract:

Purpose Although statins have been shown to reduce LDL-C and coronary heart disease risk, it is not uncommon for patients to fail to reach NCEP ATP III goals. Some statins cannot lower LDL-C sufficiently; others cannot be titrated optimally due to drug interactions and adverse effects. Concomitant ezetimibe administration can augment LDL-C reduction over statin monotherapy; however, multidrug therapy may result in additional expense. Methods We conducted a cost-effectiveness analysis (CEA) from the hospital perspective including all FDA approved statins alone (fluvastatin, lovastatin, pravastatin, simvastatin, rosuvastatin, or atorvastatin) or the following statins plus ezetimibe: lovastatin, pravastatin, simvastatin, or atorvastatin. LDL-C lowering efficacy was determined from clinical trials. Our institution's actual acquisition cost was used to approximate drug cost (US $2,004) for each statin dose alone and with ezetimibe. To test the robustness of our results a Monte Carlo simulation was conducted varying both the cost of drug and percent LDL-C reduction efficacy. Results For patients requiring less than or equal to 40% reduction from baseline in LDL-C, lovastatin 10, 20, or 40 mg, or fluvastatin 80 mg would appear to be reasonable choices based upon both efficacy and cost data. For reductions in LDL-C in the range of greater than 40%; simvastatin 40 mg plus ezetimibe 10 mg was found to be most cost effective; although, simvastatin 80 mg, rosuvastatin 20 or 40 mg, or simvastatin 80 mg plus ezetimibe 10 mg appear to be reasonably cost-effective as well. These results were not found to be robust to variations in drug cost and LDL-C reduction. Conclusion When smaller reductions in LDL-C are required (less than 40%), drug cost is the variable that most significantly drives cost effectiveness; however, when larger LDL-C reductions are required, LDL-C lowering capacity is the single most important factor in determining cost-effectiveness of the lipid-lowering therapies. The addition of ezetimibe becomes most cost-effective when larger reductions are required.

APA, Harvard, Vancouver, ISO, and other styles

47

Krobot, Karl J., Donald D. Yin, Evo Alemao, and Elisabeth Steinhagen-Thiessen. "Real-World Effectiveness of Lipid-Lowering Therapy in Male and Female Outpatients with Coronary Heart Disease: Relation to Pre-Treatment Low-Density Lipoprotein-Cholesterol, Pre-Treatment Coronary Heart Disease Risk, and other Factors." European Journal of Cardiovascular Prevention & Rehabilitation 12, no. 1 (February 2005): 37–45. http://dx.doi.org/10.1177/204748730501200106.

Full text

Abstract:

Background Determinants of the real-world effectiveness of lipid-lowering therapy have been rarely assessed in an unselected observational coronary heart disease (CHD) community cohort over time. Design Randomly drawn patients (n = 605) from randomly drawn practices (n = 62) were retrospectively followed for a median of 3.6 years (1998-2002) on lipid-lowering therapy (98% statins). Methods Coronary heart disease population-averaged estimates and variances accounting for repeated measurements within patients were obtained using generalized estimating equations. Results Post-treatment low-density lipoprotein-cholesterol (LDL-C) was 124 mg/dl in men and 141 mg/dl in women and was independently associated (all P<0.05) with pre-treatment LDL-C (+ 3.7 mg/dl per 10 mg/dl increment), female sex (+ 14.0 mg/dl), coronary bypass (-9.5 mg/dl), drug-treated diabetes mellitus (-6.8 mg/dl), and era 2002/2001 versus 1999/2000 (- 6.4 mg/dl) in age-adjusted multivariate analyses. Holding pre-treatment LDL-C constant post-treatment LDL-C was associated with pre-treatment Framingham CHD risk in men (- 13.9 mg/dl per doubling of risk), whereas LDL-C control in women resembled that in low-risk men. The likelihood of attaining LDL-C < 100 mg/dl was 0.28 in men and 0.17 in women and was likewise associated with the above factors. Conclusion Low-density lipoprotein-cholesterol control remained low despite lipid-lowering therapy across a wide range of pre-treatment LDL-C and pre-treatment CHD risk. Low-density lipoprotein-cholesterol control in women was inferior to that in men, a finding that warrants attention and clarification. Eur J Cardiovasc Prev Rehabil 12:37-45 © 2005 The European Society of Cardiology

APA, Harvard, Vancouver, ISO, and other styles

48

Plans-Rubió, P. "PCV17 COST-EFFECTIVENESS ANALYSIS OF TREATMENTS TO REDUCE CHOLESTEROL CONCENTRATION, BLOOD PRESSURE AND SMOKING FOR THE PREVENTION OF CORONARY HEART DISEASE." Value in Health 5, no. 6 (November 2002): 484. http://dx.doi.org/10.1016/s1098-3015(10)61288-0.

Full text

APA, Harvard, Vancouver, ISO, and other styles

49

Singh, Vikram, Girija Kumari, Bimal Chhajer, Ashok K. Jhingan, and Saurabh Dahiya. "ENHANCED EXTERNAL COUNTERPULSATION EFFECTIVENESS ON CLINICAL PARAMETERS IN DIABETIC AND NON-DIABETIC CORONARY HEART DISEASE PATIENTS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 7 (July 7, 2018): 151. http://dx.doi.org/10.22159/ajpcr.2018.v11i7.25219.

Full text

Abstract:

Objectives: The objectives of the study were to assess the effectiveness of enhanced external counterpulsation (EECP) treatment on clinical profile comprising physiological, biochemical, and clinical symptoms of diabetic and non-diabetic coronary heart disease (CHD) patients.Methods: A pretest–posttest designed prospective study with 163 diabetic and non-diabetic CHD patients enrolled in Science and Art of Living Heart Center (SAAOL), New Delhi, India. Angina severity was assessed using Canadian Cardiovascular Society (CCS) angina classification scale and dyspnea status was assessed using medical research council (MRC) scale. The study subjects were followed up for 12 months. Statistical analysis was done using the SPSS v21 software. Descriptive analysis with sample t-test for two independent groups and paired sample t-test for EECP effectiveness within the group was done.Results: A minute difference in body mass index mean (30.1±5.86–29.9±5.62 vs. 27.5±4.17–27.16±3.88) was observed in diabetic and non-diabetic CHD patients, but that was not statistically significant. A significant drop out in blood sugar fasting (166.7±41.9–150.1±23.7), blood sugar postprandial (204.7±64.4–173.2±41.2), and glycosylated hemoglobin (7.9±0.8 to 7.5±0.6) was also observed in diabetic CHD patients from baseline to 12th month after completion of EECP treatment with significant p<0.001, that may be due to EECP treatment. CCS angina classification score and MRC dyspnea score also significantly improved after EECP treatment.Conclusion: EECP treatment may improve clinical symptoms of CHD and lower the blood glucose level in diabetic CHD patients. This treatment may be effective for CHD patients with diabetes mellitus.

APA, Harvard, Vancouver, ISO, and other styles

50

Shugushev, Z. Kh, Yu V. Tarichko, and Yu A. Vasyuk. "Different tactics of single-stent endovascular treatment among coronary heart disease patients with coronary artery bifurcation lesions." Cardiovascular Therapy and Prevention 11, no. 2 (April 20, 2012): 39–43. http://dx.doi.org/10.15829/1728-8800-2012-2-39-43.

Full text

Abstract:

Aim. To analyze the results of different tactics of single-stent endovascular treatment among patients with coronary heart disease (CHD) and coronary artery bifurcation lesions (CABL). Material and methods. The study included 135 CHD patients with CABL. All participants were divided into 2 groups: Group I (n=77; 58,3 %) consisted of patients who underwent coronary artery (CA) main branch (MB) stenting and subsequent kissing balloon angioplasty of a CA side branch (SB). Group II (n=55) included patients with “genuine” CABL, who underwent only MB stenting with SB protection, but without SB balloon angioplasty. Results. In all 132 CABL patients, drug-eluting stents were successfully implanted, with technical effectiveness of 100 % and in-hospital survival of 100 %. Clinical outcomes were similar in both groups, with no major cardiovascular events registered. At the same time, such an important angiographic index as SB diameter was significantly higher in Group I, compared to Group II. At later stages, Group II patients required SB angioplasty and demonstrated habitual angina symptoms, ischemic electrocardiographic (ECG) changes, and slow SB blood flow (TIMI grade <III) after CA MB stenting. Conclusion. MB stenting of CA bifurcation without SB kissing balloon angioplasty cannot be recommended to all CABL patients. Development of habitual angina symptoms, ischemic ECG changes, and slow SB blood flow (TIMI grade <III) often requires subsequent SB kissing balloon angioplasty.

APA, Harvard, Vancouver, ISO, and other styles

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

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