Abstract:
BACKGROUND:The study aimed to compare the short-term costs and long-term cost-effectiveness of 2 antithrombotics, fondaparinux and enoxaparin, for non-ST-elevation acute coronary syndrome in the United States. METHODS:It was based on a large randomized trial of 20,078 patients Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators [OASIS-5] comparing the therapies in these patients. In OASIS-5, fondaparinux patients had about half the rate of major bleeding 9 days after randomization and at least as good clinical outcomes (death, myocardial infarction, major bleeding and stroke) after 6 months of follow-up. Health care resource use and clinical efficacy data from the trial were incorporated into a cost-effectiveness model as applied to a general US health care system both for the time horizon of the study (6 months) and over the longer term. RESULTS:The 180-day cost analysis indicates that fondaparinux would generate a cost saving of $547 per patient (95% CI $207-$924). Sensitivity analysis suggested that savings could vary between $494 and $733. When 180-day cost and clinical results were extrapolated to long-term cost-effectiveness, fondaparinux was dominant (less costly and more effective in terms of quality-adjusted life-years) under most scenarios. CONCLUSIONS:Fondaparinux is a more cost-effective antithrombotic agent than enoxaparin in non-ST-elevation acute coronary syndrome. This is true across the range of event risks seen in OASIS-5.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Sculpher MJ,Lozano-Ortega G,Sambrook J,Palmer S,Ormanidhi O,Bakhai A,Flather M,Steg PG,Mehta SR,Weintraub Wdoi
10.1016/j.ahj.2009.02.017subject
Has Abstractpub_date
2009-05-01 00:00:00pages
845-52issue
5eissn
0002-8703issn
1097-6744pii
S0002-8703(09)00149-5journal_volume
157pub_type
杂志文章,多中心研究,随机对照试验abstract::Besides reperfusion treatment, which is the most powerful approach to the underlying pathophysiological cause of myocardial infarction, adjunctive therapies should be considered to reduce clinical symptoms, and improve left ventricular function and mortality rates. Randomized clinical trials and overviews of adjunctiv...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/s0002-8703(99)70341-8
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:In the United States as well as globally, Asians are a growing proportion of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI), yet little is known about their longitudinal outcomes. METHODS:We linked Centers for Medicare & Medicaid claims data to detailed clinical data for 37...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2013.10.001
更新日期:2013-12-01 00:00:00
abstract::One hundred patients inducible at electrophysiologic studies underwent serial drug testing with procainamide, lidocaine, and lorcainide to determine comparative efficacy. Acute intravenous administration was followed by repeat programmed electrical stimulation (PES) studies on separate days for each antiarrhythmic dru...
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(85)90412-0
更新日期:1985-01-01 00:00:00
abstract::To assess relative capabilities of magnetic resonance (MR) imaging and two-dimensional echocardiography (2DE) for evaluating regional contractile dysfunction in the left ventricle after a myocardial infarction, results from 22 concurrent MR (orthogonal-transaxial, ECG-gated, multiphasic, single-spin echo) and 2DE exam...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90533-9
更新日期:1988-01-01 00:00:00
abstract::To evaluate the therapeutic efficacy of oral angiotensin-converting inhibition (ACE) with captopril in chronic normotensive congestive heart failure (CHF), acute and cardiocirculatory actions were determined by cardiac catheterization and forearm plethysmography, and ambulatory effects were assessed by echocardiograph...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(81)90379-3
更新日期:1981-01-01 00:00:00
abstract:BACKGROUND:To date, considerable controversy exists on the prognostic significance of morphometric endomyocardial biopsy findings in patients with idiopathic dilated cardiomyopathy (IDC). METHODS:Quantitative analyses of interstitial structured tissue, myofibril volume fraction, and myocytic fiber diameters of left ve...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00148-0
更新日期:2003-08-01 00:00:00
abstract::Several autoimmune diseases have been associated with increased frequencies of specific histocompatibility (HLA) antigens, particularly for the D (DR) locus, that may be linked to immune response genes. Rheumatic valvular heart disease (RHD) has been postulated to have autoimmune features, but HLA associations have no...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90311-x
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:Left atrial (LA) volume is a prognostic index in chronic mitral regurgitation (MR). However, little is known about LA function in this setting. We hypothesized that LA dysfunction is related to pulmonary hypertension in chronic MR. METHODS:Seventy-one patients with organic chronic MR who underwent real-time...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.05.030
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:The magnitude of benefit of cardiac resynchronization therapy (CRT) varies significantly among its recipients; approximately 30% of CRT patients do not report clinical improvement. Optimization of CRT pacing parameters can further improve cardiac function, both acutely and chronically. Echocardiographic opti...
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.2012.02.007
更新日期:2012-05-01 00:00:00
abstract::To investigate the mechanisms of restenosis and detect useful interventions to prevent it, reliable quantitative measurements must be evaluated. Coronary arteries of domestic and minipigs (n = 18) were mechanically injured by balloon overstretching and killed at different intervals (2 to 25 weeks) after quantitative a...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(93)90531-d
更新日期:1993-12-01 00:00:00
abstract::We investigated the relation between the angiographic collateral grade (Rentrop's classification) and the collateral flow velocity pattern in 43 patients with angina pectoris. Collateral flow velocity was measured with a Doppler guide wire during balloon occlusion in coronary angioplasty. Collateral flow was detected ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(95)90232-5
更新日期:1995-07-01 00:00:00
abstract::To evaluate whether the identification of the different types of relations between premature ventricular contractions (PVCs) and the preceding sinus cycle length is capable of predicting the effect of beta-blockers on the PVCs themselves, 55 patients (43 men, 12 women, mean age 52.6 +/- 15.6 years) with different card...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/s0002-8703(96)90529-3
更新日期:1996-03-01 00:00:00
abstract:BACKGROUND:AutoCapture (AC) is a programmable feature that enables the pacemaker to both track the capture threshold and automatically adjust the output on a beat-by-beat basis. Although AC safely and significantly reduces the current drainage, some authors have argued that the longevity benefit of such a system is ove...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(03)00529-5
更新日期:2004-01-01 00:00:00
abstract::To investigate the significance of atrial natriuretic polypeptide (ANP) in essential hypertension, we measured plasma ANP concentrations in 43 subjects with essential hypertension uncomplicated by cardiac or renal failure, in 16 subjects with borderline hypertension, and in 17 normotensive control subjects. Plasma ANP...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(87)90929-x
更新日期:1987-05-01 00:00:00
abstract::Fasting mongrel dogs underwent hyperbaric oxygen treatment (HBOT), recombinant tissue plasminogen activator (rt-PA) treatment, and simultaneous HBOT and rt-PA treatment following prior experimental left anterior descending coronary artery occlusion for 2 hours. Thrombosis in and around a copper coil was recorded angio...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(90)90194-3
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND:In animal models, physical activity (PA) prevents cardiac myocyte cell death. Data for PA mitigating myocyte injury in humans are limited to observational studies. Using a randomized controlled trial design, we sought to determine if introducing moderate PA to previously sedentary older adults could reduce t...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2016.07.001
更新日期:2016-09-01 00:00:00
abstract::Cross-sectional echocardiography identified two abnormal patterns of mitral valve closure in 14 patients with mitral regurgitation due to papillary muscle dysfunction: (1) in three patients with an akinetic inferior-posterior wall but normal cavity size, papillary muscle fibrosis was associated with late systolic mitr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90430-7
更新日期:1979-03-01 00:00:00
abstract::To determine the clinical usefulness of echocardiography in patients with anteroseptal myocardial infarction, echocardiograms were performed within 24 hours of admission on 40 patients with acute transmural anteroseptal myocardial infarction. Twenty-one patients had normal septal motion and septal systolic thickening,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(79)90007-3
更新日期:1979-06-01 00:00:00
abstract::The incremental advantage of transesophageal echocardiography was determined by comparing results of paired transthoracic and transesophageal echocardiographic examinations performed in 61 patients for evaluation of suspected infective endocarditis. According to clinical and pathologic data, 31 of 61 (51%) patients ha...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90519-2
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:The recent North American and European practice guidelines in patients with non-ST-segment elevation acute coronary syndrome (nSTE ACS) recommend glycoprotein IIb/IIIa (GpIIb-IIIa) inhibition in patients undergoing an early invasive treatment strategy. However, the guidelines are not explicit regarding the t...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.03.029
更新日期:2005-06-01 00:00:00
abstract:BACKGROUND:β-Blockers relieve angina/ischemia in stable coronary artery disease (CAD), and angiotensin-converting enzyme inhibitors prevent CAD outcomes. In EUROPA, the angiotensin-converting enzyme inhibitor perindopril reduced cardiovascular outcomes in low-risk stable CAD patients over 4.2 years. This post hoc analy...
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.2015.08.018
更新日期:2015-12-01 00:00:00
abstract::We examined intraindividual variability in serum TC in 2912 men and women having TC measured at each of biennial examinations 2 through 7 of the FHS. RMSE described variability around the linear slope of an individual's TC during the baseline decade. Average biennial difference +/- SD was +3.7 +/- 6.7 mg/dl in men, +6...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90393-x
更新日期:1994-06-01 00:00:00
abstract::Although cost estimates for acute myocardial infarction are necessary for decisions about allocating scarce resources, there is a relative paucity of studies that estimate these costs across the entire spectrum of hospitals in actual clinical practice. This study sought to determine the correlates of in-hospital costs...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70331-x
更新日期:1998-03-01 00:00:00
abstract::In 10 treated and 2 control dogs, the short-term effects of intravenous propafenone (2 mg/kg/10 minutes, followed by 1 mg/min [n = 2] or 25 micrograms/kg/min [n = 8]) on the internal ventricular defibrillation energy requirements (DER) were investigated. Multiple stored energy levels were randomly tested and the perce...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(91)90577-5
更新日期:1991-11-01 00:00:00
abstract::The present generation of implantable cardioverter defibrillators (ICDs) provides a very effective device for monitoring and treating life-threatening ventricular tachyarrhythmia. Patients at risk of sudden cardiac death who are directed to this form of treatment usually have severe coronary artery disease, previous m...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(94)90087-6
更新日期:1994-04-01 00:00:00
abstract::A-II exerts its activity on various target tissues by binding to its receptors. The discovery of local RASs and A-II receptors within various tissues has generated interest in the clinical usefulness of RAS inhibition by directly blocking the action of A-II at the receptor level. Different A-II receptor subtypes have ...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/0002-8703(94)90061-2
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is a major risk factor for stroke and systemic embolism. Trials comparing warfarin with non-vitamin K oral anticoagulants (NOACs) have demonstrated that, when compared with warfarin, the NOACs are at least as effective in preventing stroke, although detailed analyses characterizing s...
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.2015.06.020
更新日期:2015-10-01 00:00:00
abstract::The aim of our study was to compare the outcome of patients with a first acute myocardial infarction (AMI) among three large cohorts of patients hospitalized between 1966 and 1992 in Israel, in view of changes in treatment facilities and investigation methods. Patients with a first AMI constituted 71% of all myocardia...
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
doi:10.1016/0002-8703(95)90351-8
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. METHODS:In this open-label, m...
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.2019.06.010
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Patients with heart failure (HF) frequently have comorbidities. Frequency, prognostic, and therapeutic implications of chronic obstructive pulmonary disease (COPD) in HF are largely unknown. We aimed to assess the prevalence and prognostic implications of COPD in a sample of stable patients with HF and to de...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2007.10.040
更新日期:2008-03-01 00:00:00