Abstract:
BACKGROUND:Atrial fibrillation (AF) in the setting of heart failure (HF) is linked to embolic stroke and exacerbation of HF. The rate of new-onset AF in patients with left ventricular dysfunction and mild to moderate HF enrolled in the SoLVD trials was significantly lower with enalapril than with placebo (5.4% vs 24% over 2.9 years, P < .0001). The objective of this study was to predict economic benefits over 5 and 10 years of reduced AF incidence in patients receiving enalapril for the treatment of HF from a Canadian third-party payer perspective. METHODS:Consequences of reduced incidence of AF in enalapril-treated patients were modeled using a Markov model. Patients were assigned to 1 health state: no AF, AF, poststroke, or death, and moved from one state to the other according to published incidence rates. It was assumed that most patients with AF would receive warfarin for stroke prevention. Resource use and costs were mostly retrieved from published Canadian studies. RESULTS:Reduced incidence of AF resulted in savings of 382 dollars and 525 dollars per patient treated with enalapril over 5 and 10 years, respectively, which stemmed mainly from reduced AF hospitalization and less need for warfarin and amiodarone. Sensitivity analyses demonstrated that enalapril becomes more cost saving as the baseline risk for embolic stroke in patients with AF increases and the use of warfarin prophylaxis decreases. CONCLUSIONS:Reduced incidence of AF with enalapril leads to significant clinical and economic advantages on top of the already well-established benefits of enalapril for patients with HF.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Wagner M,Rindress D,Desjardins B,Meilleur MC,Ducharme A,Tardif JCdoi
10.1016/j.ahj.2005.07.027subject
Has Abstractpub_date
2005-11-01 00:00:00pages
985issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(05)00755-6journal_volume
150pub_type
杂志文章abstract:BACKGROUND:Although age is the most important variable associated with death among patients with persistent ST-segment elevation, its impact on outcome among patients without persistent ST-segment elevation remains unknown. Moreover, the impact of age on the efficacy of antiplatelet therapy with eptifibatide is unknown...
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:2000-05-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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doi:10.1016/0002-8703(85)90514-9
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更新日期:1996-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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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:1995-03-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:1990-11-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90008-6
更新日期:1986-06-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(93)90997-n
更新日期:1993-05-01 00:00:00
abstract::To investigate the incidence and clinical significance of postoperative pericardial effusion (PE), the presence of PE was evaluated by echocardiography, 1 and 2 weeks postoperatively, in 50 patients after insertion of a valve prosthesis and in 100 patients after coronary bypass surgery (50 patients receiving a combina...
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pub_type: 杂志文章
doi:10.1016/0002-8703(88)90255-4
更新日期:1988-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(94)90120-1
更新日期:1994-02-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(82)90052-7
更新日期:1982-11-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2016-01-01 00:00:00
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pub_type: 杂志文章,收录出版
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pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2014-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:1977-06-01 00:00:00
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更新日期:2002-08-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:2004-05-01 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.2016.12.004
更新日期:2017-03-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2013-05-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,评审
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更新日期:1999-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章,多中心研究
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更新日期:1997-10-01 00:00:00
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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:1992-11-01 00:00:00