Abstract:
BACKGROUND:Transcatheter aortic valve implantation (TAVI) is a less invasive treatment for elderly patients with aortic stenosis. However, the cost of TAVI is a major issue. This study analyzed the cost effectiveness of TAVI in Japan. METHODS:We developed an economic model to evaluate the quality-adjusted life years (QALYs) and costs of TAVI, surgical aortic valve replacement (SAVR), and medical therapy over a 10-year time horizon from the perspective of Japanese public healthcare payers. The first model compared transapical or transfemoral TAVI with Sapien valve implantation and medical therapy in inoperable patients. The second model compared transfemoral TAVI with Sapien XT valve implantation and SAVR in operable patients with intermediate surgical risk. We assumed a cost-effectiveness threshold of 5,000,000yen per QALY, and assessed the cost-effectiveness probability with 100,000 simulations. We performed a broad sensitivity analysis to assess the effect of uncertainty on our results. RESULTS:Among inoperable patients, the incremental cost-effectiveness ratio for TAVI compared with medical therapy was 3,918,808yen per QALY. In operable patients, the incremental cost-effectiveness ratio for TAVI compared with SAVR was 7,523,821yen per QALY. The cost-effectiveness probability of TAVI was 60% for inoperable patients and 46% for operable patients. Among inoperable patients, the cost-effective threshold of TAVI was <7,759,085yen. Among operable patients, the cost-effective threshold of TAVI was <5,427,439yen. CONCLUSIONS:This study suggests that TAVI has good cost effectiveness for inoperable patients, but not for operable patients.
journal_name
J Cardioljournal_title
Journal of cardiologyauthors
Kodera S,Kiyosue A,Ando J,Komuro Idoi
10.1016/j.jjcc.2017.10.008subject
Has Abstractpub_date
2018-03-01 00:00:00pages
223-229issue
3eissn
0914-5087issn
1876-4738pii
S0914-5087(17)30277-0journal_volume
71pub_type
杂志文章abstract:BACKGROUND:Optical coherence tomography (OCT) requires intracoronary injection of contrast media to remove blood from the field of view during image acquisition. Contrast injection may cause a temporal increase in intracoronary pressure. The aim of this study was to compare the intracoronary pressure during contrast in...
journal_title:Journal of cardiology
pub_type: 临床试验,杂志文章
doi:10.1016/j.jjcc.2019.08.008
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abstract:BACKGROUND:There are limited data on the impact of smoking status on outcomes after isolated coronary artery bypass graft (CABG) surgery. METHODS:Data obtained prospectively between June 2001 and December 2009 by the Australian and New Zealand Society of Cardiac and Thoracic Surgeons Cardiac Surgery Database Program w...
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2010.06.006
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abstract::Two cases of the hypoplastic right ventricle are reported. Patient 1: A five-year-old boy underwent cardiac catheterization 13 days after birth which revealed that the end-diastolic volume in the right ventricle was 2 ml. It was 20 ml at the age of two years and 40 ml at five years. Thus, the right ventricular hypopla...
journal_title:Journal of cardiology
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更新日期:1989-06-01 00:00:00
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doi:10.1016/j.jjcc.2018.04.003
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abstract::A histopathological study of coronary arteries in patients with acute coronary syndromes was carried out. The results of this study are as follows: 1. A high incidence of thrombus formation, corresponding to the site of the infarction, was observed in cases with acute myocardial infarction. 2. Coronary thrombi contain...
journal_title:Journal of cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1999-03-01 00:00:00
abstract::Spontaneous coronary artery dissection (SCAD) is a rare condition that most often presents as acute coronary syndrome or sudden cardiac death. Here we present the case of a young man of 25 years, who had remained asymptomatic in spite of SCAD. This case highlights the fact that spontaneous dissections can occur at a y...
journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2009.03.007
更新日期:2009-12-01 00:00:00
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journal_title:Journal of cardiology
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doi:
更新日期:1990-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 临床试验,杂志文章
doi:
更新日期:1999-09-01 00:00:00
abstract::A 54-year-old man was admitted as an emergency following an episode of syncope and severe dyspnea. The clinical presentation and laboratory data strongly suggested pulmonary embolism, so intravenous thrombolytic therapy was performed. Immediately following the initiation of thrombolytic therapy, the patient experience...
journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1995-09-01 00:00:00
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journal_title:Journal of cardiology
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doi:10.1016/j.jjcc.2019.12.006
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.jjcc.2009.05.011
更新日期:2009-10-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2011.06.006
更新日期:2011-09-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
abstract::The significance of abnormal high signal intensity observed in left ventricular myocardium by gadolinium-diethylenetriaminepenta-acetic acid (Gd-DTPA) enhanced magnetic resonance (MR) imaging in hypertrophic cardiomyopathy (HCM) patients was assessed by comparison with T1-weighted MR imaging, thallium-201 (201Tl) myoc...
journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1995-04-01 00:00:00
abstract::We evaluated the limits of recovery of decompensated hearts experimentally and clinically and studied the problems of applying a left ventricular assist device (LVAD). In the chronic experiments, 16 adult goats were studied as follows: Group I consisted of seven with left ventricular infarction in a 70-80% area of the...
journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1999-12-01 00:00:00
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doi:
更新日期:2007-11-01 00:00:00
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doi:
更新日期:2006-06-01 00:00:00
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更新日期:2009-08-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:2007-05-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2020-04-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jjcc.2019.01.007
更新日期:2019-08-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:2007-06-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:10.1016/j.jjcc.2019.09.006
更新日期:2020-04-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1988-03-01 00:00:00
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journal_title:Journal of cardiology
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00