Abstract:
OBJECTIVE:The purpose of this study was to estimate the cost-effectiveness of beta-blocker therapy with either metoprolol or carvedilol in addition to conventional therapy for patients with heart failure (HF) in Canada. DESIGN:A Markov simulation was used to estimate the costs and life expectancy for treating patients with conventional therapy alone and with the addition of metoprolol or carvedilol. Although carvedilol has been marketed in Canada since 1999, metoprolol succinate has yet to be marketed there, so the price is unknown. Therefore we input a Canadian price based on the price ratio of the 2 drugs in the United States. RESULTS:For subjects aged 60 years at HF onset, the expected years of life are 4.53 years for those treated with conventional therapy alone, 5.70 years for those who receive conventional therapy plus metoprolol, and 6.21 years for those who receive conventional therapy plus carvedilol. The expected costs (in 1999 Canadian dollars) are $8,989, $13,833, and $18,114, respectively. This yields incremental cost-effectiveness ratios (ICERs) for metoprolol relative to conventional therapy alone of $4,140 per life-year gained, and for carvedilol relative to metoprolol, the ICER is $8,394 per life-year gained. CONCLUSIONS:In addition to conventional therapy with furosemide and angiotensin converting enzyme inhibitors, treatment with either metoprolol or carvedilol confers a survival benefit that is attractive from a cost-effectiveness point of view. Until better information becomes available, it is not possible to distinguish between the two beta-blockers on the basis of cost-effectiveness. This means that the choice of beta-blockers for HF should be based largely on clinical considerations because both beta-blockers prolong life at relatively low cost.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Levy AR,Briggs AH,Demers C,O'Brien BJdoi
10.1067/mhj.2001.116479subject
Has Abstractpub_date
2001-09-01 00:00:00pages
537-43issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(01)32977-0journal_volume
142pub_type
杂志文章abstract::One hundred four patients (101 men, three women), under 40 years of age, with myocardial infarction (MI), underwent coronary arteriography. Eighty patients had significant obstructive coronary artery disease (CAD) (group 1), 23 had normal coronary arteries (group 2), and one patient had coronary ostial stenosis as a r...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90680-0
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND:Postinterventional cognitive dysfunction (PICD) is a known complication of coronary artery bypass grafting (CABG). However, it is largely unknown whether PICD occurs after coronary catheterization. METHODS:Neuropsychologic data were obtained from 37 patients who received coronary catheterization and 47 pati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.07.021
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:In patients with acute myocardial infarction (AMI), depressive symptoms increase the risk for cardiac events. Recently, the S allele of the serotonin transporter (5-HTT) gene-linked polymorphic region was shown to reduce transcription of this gene and thus reduce serotonin reuptake, and this allele is linked...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.062
更新日期:2005-10-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(93)90707-g
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Type III hyperlipoproteinemia is characterized by the accumulation of chylomicron and very low density lipoprotein (VLDL) remnants. Individuals with this disorder have a high risk of premature atherosclerosis, and hypolipidemic drugs are useful in their management. METHODS:We compared, in a double-blind, pl...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1999-07-01 00:00:00
abstract::To determine whether any differences exist in results of treatment of restenosis with repeat angioplasty when the procedure is performed during diagnosis or, as an alternative, when it is performed as a separate elective procedure, we prospectively compared the outcome of 48 consecutive procedures (including 51 lesion...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(05)80010-9
更新日期:1990-02-01 00:00:00
abstract::The presence and severity of functional mitral regurgitation were quantified by Doppler echocardiography in 17 patients with dilated cardiomyopathy and no evidence of primary valvular disease. Mitral regurgitant fraction was greater than 20% in 11 of the 17 patients, and exceeded 40% in four patients. Total stroke vol...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90334-1
更新日期:1988-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90519-n
更新日期:1991-09-01 00:00:00
abstract::Combination therapy with mexiletine (MEX) and quinidine (Q) may be more efficacious than monotherapy with either drug in suppressing ventricular arrhythmias, but its effects on ventricular performance are not known. Thus, right ventricular ejection fraction (RVEF) and left ventricular ejection fraction (LVEF) and wall...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(88)90072-5
更新日期:1988-05-01 00:00:00
abstract::Cardiopulmonary resuscitation-generated coronary perfusion pressure and intracoronary flow velocity was studied with high-fidelity pressure transducers and an intracoronary Doppler catheter in 11 swine undergoing closed-chest manual cardiopulmonary resuscitation. Retrograde coronary blood flow in the mid left anterior...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90622-x
更新日期:1994-09-01 00:00:00
abstract::Head-up tilt provokes vasodepressor syncope in patients with this disorder but may also cause fainting in unaffected subjects. The aims of this study were to examine autonomic function and sequential changes in heart rate variability and plasma catecholamines during graded head-up tilt in patients with vasodepressor s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70213-8
更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:Congestive heart failure (CHF) and heart transplantation (HTX) are characterized by endothelial dysfunction as indicated by elevation of markers of endothelial function, including endothelin and von Willebrand factor (vWF). However, previous studies included both patients with idiopathic dilated cardiomyopat...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70505-3
更新日期:1999-03-01 00:00:00
abstract::For 29 patients with congestive heart failure (CHF), 24-hour noninvasive ambulatory blood pressure (ABP) and heart rate (HR) measurement profiles were described, using the periodogram method, and were compared with the same findings in 22 matched controls. Right-sided heart catheterization was performed in all patient...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90710-d
更新日期:1992-04-01 00:00:00
abstract::The results of percutaneous transluminal coronary angioplasty (PTCA) in 307 lesions in 235 patients within 60 days of myocardial infarction (MI) were compared with the PTCA results in 591 lesions in 489 patients without recent MI, and the effect of fibrinolysis to treat recurring occlusive clot during angioplasty was ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90065-6
更新日期:1990-08-01 00:00:00
abstract:AIM:The EARISA Registry was designed to describe diagnostic and therapeutic resources used in Italian cardiology centers for patients with the epidemiologically most relevant cardiac diseases. This article focuses on patients with unstable angina; characteristics associated with invasive procedures were specifically an...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1067/mhj.2000.107997
更新日期:2000-08-01 00:00:00
abstract::Because limited information is available on significant arrhythmias after myocardial infarction in pediatric patients, this study was performed to determine the incidence and impact of ventricular tachycardia or fibrillation on the postinfarction course in patients aged 1 day to 16 years. Review of 96 such children sh...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90400-x
更新日期:1995-06-01 00:00:00
abstract::An extremely athletic 56-year-old male physician was found to have profound sinus bradycardia. His only symptom was markedly increased alertness while actively exercising. During pacemaker insertion he had an episode of prolonged sinus arrest terminated by a precordial thump. This case suggests that exercise can alter...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90284-7
更新日期:1980-07-01 00:00:00
abstract::We evaluated the use of simple balloon overinflation to induce neointimal hyperplasia in a porcine model of coronary artery restenosis. By using standard percutaneous transluminal coronary angioplasty techniques, left anterior descending (LAD) and/or left circumflex (LCX) coronary arteries of either juvenile feeder pi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90505-3
更新日期:1994-01-01 00:00:00
abstract::To test the hypothesis that elevated plasma levels of natriuretic peptides may serve to identify patients with left ventricular (LV) dysfunction, we assessed the predictive diagnostic value of natriuretic peptide levels, in addition to clinical and electro-cardiographic risk factors, as noninvasive indicators of cardi...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70079-6
更新日期:1997-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,meta分析
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更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Firm evidence exists for reduction in mortality and morbidity by lipid-lowering therapy in patients with coronary artery disease (CAD), yet a significant proportion remain untreated. This prospective study determined the effectiveness of a planned strategy of management using a cardiac rehabilitation nurse i...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
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更新日期:2001-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:1999-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.ahj.2015.10.017
更新日期:2016-02-01 00:00:00
abstract::Repetitive 10-hour ECG recordings of 289 patients obtained within a year after myocardial infarction were analyzed for the presence of ventricular runs, and their association with various types of ventricular ectopic activity (VEA), average rate of premature ventricular complexes (PVCs), and coupling interval of PVCs ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(83)90690-7
更新日期:1983-09-01 00:00:00
abstract::The effects of two regimens for the initiation of amiodarone therapy were compared in 92 patients with inducible sustained ventricular tachycardia (VT) at baseline electrophysiologic testing. Two groups of 46 patients each received a total of 16.8 gm of oral amiodarone before follow-up electrophysiologic testing. Grou...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(92)90599-q
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:Randomized trials have established efficacy of clopidogrel in various types of acute coronary syndromes (ACS). The objective of this study was to examine the temporal trends and patterns of early clopidogrel use (within the first 24 hours of hospitalization) across the spectrum of patients with ACS in Canada...
journal_title:American heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ahj.2009.01.002
更新日期:2009-04-01 00:00:00
abstract::To evaluate the mechanisms involved in nitrate tolerance, we randomized 23 patients with congestive heart failure resulting from coronary artery disease to an isosorbide dinitrate or a molsidomine infusion. The drugs were titrated to decrease pulmonary capillary wedge pressure by > or = 30% or > or = 10 mm Hg. Then is...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(94)90632-7
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Clinical outcomes and the effects of oral anticoagulants among patients with acute coronary syndrome (ACS) and either a history of or acute heart failure (HF) are largely unknown. We aimed to assess the relationship between prior HF or acute HF complicating an index ACS event and subsequent clinical outcomes...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2014.12.022
更新日期:2015-04-01 00:00:00
abstract::Six hundred fifty seven patients with angina pectoris underwent coronary angiography after measurement of plasma fibrinogen levels. Coronary artery disease (CAD) was angiographically confirmed in 75% of the patients. Other cardiac disease, either alone or in combination with CAD, was diagnosed in 8% and 11% of cases, ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90747-w
更新日期:1993-06-01 00:00:00
abstract::A 35-year-old man suffered transmural diaphragmatic wall infarction immediately after receiving a nonpenetrating trauma to his chest. During subsequent months crippling angina pectoris developed and coronary arteriography was performed. A complete obstruction of the left circumflex coronary artery was demonstrated 2 c...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(76)80051-8
更新日期:1976-10-01 00:00:00