Abstract:
BACKGROUND:Compared with single-chamber ventricular pacing, dual-chamber pacing can reduce adverse events and, as a result, improve quality of life in patients paced for sick sinus syndrome. It is not clear, however, how these benefits compare with the increased cost of dual-chamber pacemakers. METHODS AND RESULTS:We used 4-year data from a 2010-patient, randomized trial to estimate the incremental cost-effectiveness of dual-chamber pacing compared with ventricular pacing and then projected these findings over the patients' lifetimes by using a Markov model that was calibrated to the first 5 years of in-trial data. To assess the stability of the findings, we performed 1000 bootstrap analyses and multiple sensitivity analyses. During the first 4 years of the trial, dual-chamber pacemakers increased quality-adjusted life expectancy by 0.013 year per subject at an incremental cost-effectiveness ratio of 53,000 dollars per quality-adjusted year of life gained. Over a lifetime, dual-chamber pacing was projected to increase quality-adjusted life expectancy by 0.14 year with an incremental cost-effectiveness ratio of approximately 6800 dollars per quality-adjusted year of life gained. In bootstrap analyses, dual-chamber pacing was cost-effective in 91.9% of simulations at a threshold of 50,000 dollars per quality-adjusted year of life and in 93.2% of simulations at a threshold of 100,000 dollars. Its cost-effectiveness ratio was also below this threshold in numerous sensitivity analyses that varied key estimates. CONCLUSIONS:For patients with sick sinus syndrome requiring pacing, dual-chamber pacing increases quality-adjusted life expectancy at a cost that is generally considered acceptable.
journal_name
Circulationjournal_title
Circulationauthors
Rinfret S,Cohen DJ,Lamas GA,Fleischmann KE,Weinstein MC,Orav J,Schron E,Lee KL,Goldman Ldoi
10.1161/01.CIR.0000151810.69732.41subject
Has Abstractpub_date
2005-01-18 00:00:00pages
165-72issue
2eissn
0009-7322issn
1524-4539pii
01.CIR.0000151810.69732.41journal_volume
111pub_type
杂志文章相关文献
CIRCULATION文献大全abstract:BACKGROUND:Clinical manifestations of acute myocarditis, with distinct onset, vary from asymptomatic to fatal. The predictors of the course of the disease in patients with acute myocarditis at initial presentation have not yet been established. In this study, we examined the predictive values of various parameters in t...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.102.23.2829
更新日期:2000-12-05 00:00:00
abstract:BACKGROUND:This study evaluated the hypothesis that transendocardial injections of autologous mononuclear bone marrow cells in patients with end-stage ischemic heart disease could safely promote neovascularization and improve perfusion and myocardial contractility. METHODS AND RESULTS:Twenty-one patients were enrolled...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.CIR.0000070596.30552.8B
更新日期:2003-05-13 00:00:00
abstract:BACKGROUND:In vivo testing of novel antiplatelet agents requires informative biomarkers. By genetically modifying mouse von Willebrand factor (VWF(R1326H)), we have developed a small animal model that supports human but not mouse platelet-mediated thrombosis. Here, we evaluate the use of this biological platform as a p...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.110.951970
更新日期:2011-01-25 00:00:00
abstract:BACKGROUND:Hypercholesterolemia is a risk factor for coronary disease, and platelet reactivity is increased with hypercholesterolemia, suggesting a prethrombotic risk. The aim of this study was to measure mural platelet thrombus formation on an injured arterial wall in a model simulating vessel stenosis and plaque rupt...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.11.3172
更新日期:1995-12-01 00:00:00
abstract:BACKGROUND:The cytoskeleton plays an important role in maintaining cell structure and integrity. Defects in cytoskeletal proteins can cripple cell strength and may cause cardiomyopathy. We analyzed heart tissues from subjects with dilated cardiomyopathy for abnormalities in the cardiac cytoskeleton. Metavinculin, a car...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.95.1.17
更新日期:1997-01-07 00:00:00
abstract:BACKGROUND:Despite successful surgical correction, morbidity of patients with coarctation of the aorta is increased. It is well known that these patients have impaired elastic properties of the prestenotic arteries. To find out whether these abnormalities are primarily present or develop later, we studied 17 newborns b...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.104.529792
更新日期:2005-06-21 00:00:00
abstract:BACKGROUND:Thrombi are known to induce activation of the coagulation system, which may be a mechanism for progression of thrombosis and its recurrence after thrombolysis. This study was designed to characterize the relative role of thrombin and activated factor X (factor Xa) as mediators of procoagulant activity of who...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.4.962
更新日期:1995-08-15 00:00:00
abstract::All physicians increasingly will encounter patients who have implanted cardioverter-defibrillators (ICDs) for protection from ventricular arrhythmias. This advisory provides a concise summary relevant to the assessment and management of patients with ICDs, including those who present to primary care or emergency depar...
journal_title:Circulation
pub_type: 杂志文章,评审
doi:10.1161/01.CIR.0000149716.03295.7C
更新日期:2004-12-21 00:00:00
abstract:BACKGROUND:CXCL16/SR-PSOX is an interferon-gamma-regulated chemokine and scavenger receptor for oxidized low-density lipoprotein that is expressed in atherosclerotic lesions. Proteolytic cleavage of membrane-bound CXCL16 releases soluble CXCL16, which may promote migration of effector T cells and augment a proatherogen...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.806877
更新日期:2009-06-30 00:00:00
abstract:BACKGROUND:Comprehensive data based on single-beat analysis of the ventricular activation sequence during sinus rhythm in infarcted hearts are currently not available. It was the aim of our study (1) to measure and analyze these activation sequences on the epicardial surface of the right and left ventricles and on the ...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.91.5.1480
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:To determine, using systematic review of the biomedical literature, whether pacing reduces risk of recurrent syncope and relevant clinical outcomes among adult patients with reflex-mediated syncope. METHODS:MEDLINE (through PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials (through Oct...
journal_title:Circulation
pub_type: 杂志文章,meta分析,评审
doi:10.1161/CIR.0000000000000500
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Transplant-associated coronary artery disease (TxCAD) is the manifestation of chronic rejection in the cardiac allograft. Both immunological and nonimmunological factors contribute to its development. Stratification by the time of development of TxCAD has not been considered previously for an extensive trans...
journal_title:Circulation
pub_type: 杂志文章
doi:
更新日期:1997-11-04 00:00:00
abstract:BACKGROUND:The present study was designed to define the prevalence and characteristics of skeletal muscle alterations in patients with chronic heart failure (CHF) and their relation to exercise capacity. METHODS AND RESULTS:The ultrastructure of skeletal muscle was analyzed by ultrastructural morphometry in 57 patient...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.85.5.1751
更新日期:1992-05-01 00:00:00
abstract:BACKGROUND:Patients with diabetes mellitus (DM) are at high risk of developing congestive heart failure (CHF). However, the relationships between glucose levels and CHF in people with or without a history of DM have not been well characterized. METHODS AND RESULTS:We evaluated the associations between fasting plasma g...
journal_title:Circulation
pub_type: 杂志文章,随机对照试验
doi:10.1161/CIRCULATIONAHA.106.661405
更新日期:2007-03-20 00:00:00
abstract:BACKGROUND:Elevated levels of oxidized phospholipids (OxPLs) on apolipoprotein B-100 particles (OxPL/apoB) are associated with cardiovascular disease and predict new cardiovascular events. Elevated lipoprotein (a) [Lp(a)] levels are a risk factor for cardiovascular disease in whites and also in blacks if they carry sma...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.108.836940
更新日期:2009-04-07 00:00:00
abstract:BACKGROUND:While previous clinical studies have shown a possible beneficial effect of the reperfusion performed at a relatively late phase of acute myocardial infarction ("late reperfusion") in preventing left ventricular enlargement, the mechanism has not been clarified. METHODS AND RESULTS:Of 89 patients with an ini...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/01.cir.88.6.2565
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Regional sympathetic denervation, such as that produced by a myocardial infarction, causes electrophysiological heterogeneity in the ventricles. The purpose of this study was to test the hypothesis that such denervation could cause drugs to exert heterogeneous myocardial effects. METHODS AND RESULTS:Sympath...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.84.4.1709
更新日期:1991-10-01 00:00:00
abstract:BACKGROUND:Data on outcomes after Stanford type A aortic dissection in patients with Marfan syndrome are limited. We investigated the primary surgery and long-term results in patients with Marfan syndrome who suffered aortic dissection. METHODS AND RESULTS:Among 1324 consecutive patients with aortic dissection type A,...
journal_title:Circulation
pub_type: 杂志文章,多中心研究
doi:10.1161/CIRCULATIONAHA.113.005865
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Although aspirin is an effective, inexpensive, and safe treatment of acute myocardial infarction, the frequency of use of aspirin in actual medical practice is not known. Elderly patients, a group with low rates of utilization of effective therapies such as thrombolytic therapy, also may be at risk of not re...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.92.10.2841
更新日期:1995-11-15 00:00:00
abstract::The pulmonary perfusion of 25 children who had total surgical correction of tetralogy of Fallot was evaluated by radionuclide perfusion scans. In addition, 18 had 133Xe ventilation studies. Eighteen of the children previously had palliative systemic-pulmonary shunts; 14 had aortic-pulmonary shunts (Waterston or Potts-...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.53.2.332
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Myocardial perfusion reflects the macro- and microvascular coronary circulation. Recent quantitation developments using cardiovascular magnetic resonance perfusion permit automated measurement clinically. We explored the prognostic significance of stress myocardial blood flow (MBF) and myocardial perfusion r...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.119.044666
更新日期:2020-04-21 00:00:00
abstract:BACKGROUND:Oxidative stress activates endothelial innate immunity and disrupts endothelial functions, including endothelial nitric oxide synthase-derived nitric oxide bioavailability. Here, we postulated that oxidative stress induces sterol regulatory element-binding protein 2 (SREBP2) and microRNA-92a (miR-92a), which...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/CIRCULATIONAHA.114.013675
更新日期:2015-03-03 00:00:00
abstract::Trapidil (triazolopyrimidine) possesses activity against platelet-derived growth factor-induced cellular proliferation in vitro and intimal proliferation in vivo. The objective of this study was to determine if trapidil could prevent restenosis in experimentally induced atherosclerotic rabbits. New Zealand White rabbi...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.81.3.1089
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:Cystic medial degeneration (CMD) is a histological abnormality that is common in the aortic diseases associated with Marfan's syndrome (MFS). Although little known about the mechanism underlying CMD, several recent reports have demonstrated that vascular smooth muscle cell (VSMC) apoptosis could play a subst...
journal_title:Circulation
pub_type: 临床试验,杂志文章
doi:10.1161/hc37t1.094856
更新日期:2001-09-18 00:00:00
abstract:BACKGROUND:Macrophages in human atherosclerotic plaques produce a family of matrix metalloproteinases (MMPs), which may influence vascular remodeling and plaque disruption. Because oxidized LDL (ox-LDL) is implicated in many proatherogenic events, we hypothesized that ox-LDL would regulate expression of MMP-9 and tissu...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.99.8.993
更新日期:1999-03-02 00:00:00
abstract:BACKGROUND:There is increasing evidence of a link between conduit vessel stiffness and cardiovascular events, although the association has never been tested in a large post-myocardial infarction patient population. METHODS AND RESULTS:We evaluated the relationship between baseline pulse pressure, measured by sphygmoma...
journal_title:Circulation
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1161/01.cir.96.12.4254
更新日期:1997-12-16 00:00:00
abstract::One of the noninvasive methods of evaluating left ventricular performance is the measurement of left ventricular systolic time intervals (LVSTI). However, noninvasive measurement of right ventricular systole by this technique has been unreliable because of the inability to accurately time the onset of right ventricula...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.51.2.304
更新日期:1975-02-01 00:00:00
abstract:BACKGROUND:The effects of carteolol, a nonselective beta-adrenergic receptor blocker with intrinsic sympathomimetic activity, were compared with those of metoprolol in a murine model of viral myocarditis and dilated cardiomyopathy caused by encephalomyocarditis virus. METHODS AND RESULTS:In the acute experiment, BALB/...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.83.6.2021
更新日期:1991-06-01 00:00:00
abstract::The elimination of specific dietary cholesterol target recommendations in recent guidelines has raised questions about its role with respect to cardiovascular disease. This advisory was developed after a review of human studies on the relationship of dietary cholesterol with blood lipids, lipoproteins, and cardiovascu...
journal_title:Circulation
pub_type: 杂志文章,meta分析
doi:10.1161/CIR.0000000000000743
更新日期:2020-01-21 00:00:00
abstract:BACKGROUND:Previous studies have documented the strong association between availability of on-site cardiac catheterization facilities and increased use of coronary angiography in patients with acute myocardial infarction (AMI). Although these studies have shown little influence of the availability of catheterization la...
journal_title:Circulation
pub_type: 杂志文章
doi:10.1161/01.cir.96.6.1770
更新日期:1997-09-16 00:00:00