Abstract:
:Cardiovascular disease is the leading cause of morbidity and mortality with annual costs of care exceeding 300 billion US dollars. Although screening tools are advocated for many cancers, the use of subclinical disease tests for cardiovascular disease are considered controversial. Health care payers and many governmental agencies apply cost-effectiveness analysis for the evaluation of new technology being considered for routine application in the US and Europe. Cost-effectiveness analysis by definition provides a comparative analysis of clinical and economic outcome data when evaluating new technology in relation to existing modalities. The current report provides a description of the framework upon methods applied in cost-effectiveness analysis as well as available data on the subject of cardiovascular screening, most notably using the evaluation of coronary calcium screening with electron beam tomography. The current report will also present several decision analytic models on the cost of atherosclerotic imaging including the evaluation of serial monitoring for disease progression and the development of cost-effectiveness models employing intermediate outcomes. Based on this review, there is an unfolding body of evidence that explores both the clinical and economic consequences of screening for atherosclerotic diseases. Although further evidence is required from prospectively designed randomized controlled trials, it appears that the current evidence from small series and decision analytic models supports cardiovascular screening of asymptomatic individuals and that the current results reveal enhanced cost effectiveness when compared with the routine evaluation using a Framingham risk assessment.
journal_name
Prog Cardiovasc Disjournal_title
Progress in cardiovascular diseasesauthors
Shaw LJ,Raggi P,Berman DS,Callister TQdoi
10.1016/s0033-0620(03)00085-9subject
Has Abstractpub_date
2003-09-01 00:00:00pages
171-84issue
2eissn
0033-0620issn
1873-1740pii
S0033062003000859journal_volume
46pub_type
杂志文章,评审abstract::Stents or endoprostheses have evolved since their introduction. Initially used only in the vascular system, the use of stents has expanded to use in the biliary, urinary, and gastrointestinal tracts and in the tracheo-bronchial tree. Current use of stents includes treatment of both benign and malignant conditions, wit...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/s0033-0620(96)80025-9
更新日期:1996-09-01 00:00:00
abstract::The application of ultrasound to clinical evaluation of the symptomatic patient requires less precision and accuracy than when it is used as an instrument to study atherogenesis. The clinician's goal is to locate hemodynamically significant lesions; studies of atherogenesis require auxometry (measurement of the growth...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章
doi:10.1016/0033-0620(84)90007-0
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:To perform a pilot evaluation of a pharmacist-led, multidisciplinary transitional care clinic for heart failure (HF) patients. BACKGROUND:Transitions of care in HF should include: medication reconciliation, multidisciplinary care, early post-discharge follow-up, and prompt intervention on HF signs and sympto...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章
doi:10.1016/j.pcad.2017.08.005
更新日期:2017-01-01 00:00:00
abstract::Slow channel inhibiting agents, particularly verapamil, appear to produce beneficial effects in relieving symptoms of dyspnea, chest pain, and syncope or presyncope in over 70% of patients with hypertrophic cardiomyopathy. Symptomatic relief occurs in patients with and without left ventricular outflow obstruction. Exe...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(82)90016-0
更新日期:1982-11-01 00:00:00
abstract::Pulmonary and/or tricuspid valve dysfunction is common among individuals with congenital heart disease, and surgical intervention often carries prohibitive risks. Transcatheter valve replacement (TVR) of the right-sided cardiac valves has become a viable treatment option over the past two decades, while continued tech...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2018.09.003
更新日期:2018-01-01 00:00:00
abstract::Valvular heart disease (VHD) carries documented risks for active individuals. At the same time, many individuals with intermediate degrees of valve disease can safely exercise and even participate in competitive athletics. Unfortunately for clinicians caring for these patients, data are scarce. Understanding the patho...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2011.02.010
更新日期:2011-05-01 00:00:00
abstract::The underlying causes of hypertensive disease remain unclear. This article has attempted to highlight potential dysfunctions in arterial pressure regulation which could either initiate or sustain the hypertensive process. As has been suggested innumerable times hypertension must certainly be a multifactorial abnormali...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(76)90001-3
更新日期:1976-03-01 00:00:00
abstract::The QT Variability Index (QTVI) is a non-invasive measure of repolarization lability that has been applied to a wide variety of subjects with cardiovascular disease. It is a ratio of normalized QT variability to normalized heart rate variability, and therefore includes an assessment of autonomic nervous system tone. T...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2013.07.004
更新日期:2013-09-01 00:00:00
abstract::Functional tricuspid regurgitation (FTR) has been neglected for a long time, however its prevalence and clinical relevance is not negligible. In presence of FTR, a certain quote of annular dilatation is present thus contributing to the mechanism of regurgitation. Historically, surgical annuloplasty has been the main t...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2019.10.002
更新日期:2019-01-01 00:00:00
abstract::The repetitive respiratory events that characterize obstructive sleep apnea (OSA) are each followed by abrupt increases in heart rate and in pulmonary and systemic artery pressure and by sudden decreases in right and left ventricular stroke volume. The changes in systemic pressure may be profound, with patients who ar...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1053/pcad.1999.0410367
更新日期:1999-03-01 00:00:00
abstract::Physical inactivity is one of the major contributing factors to the global pandemic of non-communicable diseases. Unfortunately, low levels of habitual movement and physical activity (PA) are seen in an increasing proportion of populations across low- and middle-income countries and high-income countries alike. This n...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2020.10.006
更新日期:2020-10-30 00:00:00
abstract::There is concern in published reports and reviews that patients are being harmed or denied effective treatment by the use of questionable results from secondary analyses of data from clinical trials. A well-reported secondary analysis must make clear to the reader the uncertainty of the result--so clear, in fact, that...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2011.09.006
更新日期:2012-01-01 00:00:00
abstract::Multimorbidity is the most common chronic health condition in adults and is associated with poor health outcomes. Optimal care for people with multimorbidity requires a person-centred approach that considers goals and preferences, improves quality of life and coordinates care across services. Because care is focused o...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2018.12.010
更新日期:2019-01-01 00:00:00
abstract::In contrast to heart transplantation, little effort has been made to estimate the economic implications of mechanical cardiac assistance from either a procedure- or a program-level perspective. With annual direct and indirect expenditures for the treatment of coronary artery disease and congestive heart failure now ex...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1053/pcad.2000.7201
更新日期:2000-07-01 00:00:00
abstract::Physicians who supervise stress-imaging procedures, whether they be stress nuclear or stress echocardiography tests, are increasingly required to incorporate important principles in the interpretation of the test results. Important guiding principles, common to these tests, are reviewed in this article. The principles...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章
doi:10.1053/pcad.2001.20501
更新日期:2001-01-01 00:00:00
abstract::The revolution in cardiac care over the past two decades, characterized by emergent revascularization, drug eluting stents, anti-platelet medications, and advanced imaging has had little impact on overall ACS recurrence, or ACS prevention. The "Perfect Storm" refers to a confluence of events and processes, including a...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2013.03.003
更新日期:2013-05-01 00:00:00
abstract::There is a strong evidence that more marked lowering of low-density lipoprotein cholesterol (LDL-C) leads to progressively lower risk of cardiovascular disease (CVD) events. The evidence on validity of this hypothesis comes from epidemiological, genetic and clinical studies. The hypothesis "the lower the better" has b...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2020.12.008
更新日期:2020-12-28 00:00:00
abstract::The PREDIMED (PREvención con DIeta MEDiterránea) multicenter, randomized, primary prevention trial assessed the long-term effects of the Mediterranean diet (MeDiet) on clinical events of cardiovascular disease (CVD). We randomized 7447 men and women at high CVD risk into three diets: MeDiet supplemented with extra-vir...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2015.04.003
更新日期:2015-07-01 00:00:00
abstract::Heparin has been the principal anticoagulant in the management of ST-elevation myocardial infarction (STEMI) but has several limitations. Although glycoprotein IIb/IIIa inhibitors have been major adjuncts in previous years, in the era of novel P2Y12 receptor inhibitors they may have a greater role in bailout. Low mole...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2015.08.007
更新日期:2015-11-01 00:00:00
abstract::The integrated response to severe exercise involves fourfold to fivefold increases in cardiac output, which are due primarily to increases in cardiac rate and to a lesser extent to augmentation of stroke volume. The increase in stroke volume is partly due to an increase in end-diastolic cardiac size (Frank-Starling me...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(76)90018-9
更新日期:1976-09-01 00:00:00
abstract::Mitral regurgitation (MR) is the one of the most frequent valvular heart diseases in the developed world, often requiring surgical correction. Degenerative MR is the most common type of non-ischemic, organic MR in the western world. Since no medical treatment has been shown to be effective in preventing the consequenc...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2017.10.005
更新日期:2017-01-01 00:00:00
abstract::There are >1.4 million adult congenital heart disease (CHD; ACHD) patients living in the United States. Coronary artery disease (CAD) is at least as prevalent in ACHD patients as in the general population and has become a leading cause of their mortality. In the majority of cases, CAD in the ACHD population is driven ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2018.07.018
更新日期:2018-01-01 00:00:00
abstract::Since the early 1900s, coffee has been implicated as having adverse effects on human health. Recent attention has focused on coffee's relation to CHD, but because of conflicting results of epidemiologic studies on coffee and CHD mortality, attention has turned to the effects of coffee and caffeine on individual CHD ri...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/0033-0620(89)90028-5
更新日期:1989-11-01 00:00:00
abstract::The purpose of this article is to highlight approaches to increase movement, physical activity (PA), and cardiorespiratory fitness, and reduce sedentary behavior (SB) in the context of the workplace. A deliberate strategy that will enable the successful promotion of movement at the workplace includes a business plan a...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2020.10.004
更新日期:2020-10-24 00:00:00
abstract::Mitral regurgitation (MR) is the most prevalent cause of valvular heart disease (VHD) in western countries. In the Euro Heart Survey on VHD, MR was the second most common heart VHD requiring surgery. It is also the most common form of VHD in community and population-based studies from the United States. The categoriza...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2017.11.008
更新日期:2017-01-01 00:00:00
abstract::Pulmonary artery hypertension is a complex and multi-faceted disease process with numerous etiologies. Chronic thromboembolic pulmonary hypertension (CTEPH) is an underdiagnosed and highly treatable form of pulmonary hypertension. In this disease, certain patients with a history of pulmonary thromboembolic disease go ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2012.07.005
更新日期:2012-09-01 00:00:00
abstract::Stem cells are potential agents for the treatment of myocardial infarcts among other heart diseases. Over the past decade, the scientific community has extensively used a wide variety of cells and examined their capacity to both regenerate the infarcted myocardium and improve functionally the diseased hearts. Some of ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2007.02.006
更新日期:2007-05-01 00:00:00
abstract::The direct medical cost of cardiovascular and circulatory diseases was $151 billion in 1995, approximately 17% of all direct medical care costs in the United States. Incidence and prevalence based estimates indicate that smoking is a major contributing factor for cardiovascular disease and associated costs. Statewide ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/s0033-0620(03)00077-x
更新日期:2003-07-01 00:00:00
abstract::There has been a lot of progress in measurement techniques of the pulmonary circulation in recent years, and this has required updating of basic physiological knowledge. Pulmonary artery pressures (PAP) are normally low and dependent on left atrial pressure (LAP) and cardiac output (CO). Therefore, defining the functi...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/j.pcad.2014.12.003
更新日期:2015-03-01 00:00:00
abstract::Two central concepts of human hypertensive disease remain poorly understood: (1) elevated blood pressure as merely one component of an underlying systemic condition, characterized by multiple defects in diverse tissues (eg, "Syndrome X"), and (2) the heterogeneity of hypertension, in which different and even opposite ...
journal_title:Progress in cardiovascular diseases
pub_type: 杂志文章,评审
doi:10.1016/s0033-0620(99)70006-x
更新日期:1999-07-01 00:00:00