Abstract:
:Health economics is about spending limited resources wisely and, as with so many fields in medicine, combines science with art and ingenuity. In order to know whether money is well spent it is necessary to have some reference points to make comparisons. Many accepted cardiovascular interventions, such as revascularization for multivessel disease (US$50000 per life year gained) or the use of a statin for hypercholesterolaemia in middle-aged men at high risk of cardiovascular events (US$30000 per life year gained) are associated with moderate expense. By contrast heart failure is one of the few conditions in which, under some circumstances, lives may be saved while significantly reducing costs. This article seeks to review currently available reports on the health economic consequences of interventions for heart failure and describes the development of a new health economic model. Digoxin, ACE inhibitors and beta-blockers all appear to be cost-effective under widely differing sets of assumptions. Estimates range from a substantial cost-saving to a few thousand dollars per life year gained. The major factor limiting the reduction in costs associated with effective treatment for heart failure (with the exception of digoxin) is the costs incurred as a consequence of improved longevity. Money spent on treating heart failure well is money wisely spent.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Cleland JGsubject
Has Abstractpub_date
1998-12-01 00:00:00pages
P32-9eissn
0195-668Xissn
1522-9645journal_volume
19 Suppl Ppub_type
杂志文章,评审abstract::Supraventricular tachycardia is due to altered automaticity, triggered activity or most commonly, reentry. Atrial flutter is most frequently due to reentry with counterclockwise activation in the right atrium with the left atrium acting as a bystander. The small wavefronts demonstrated during atrial fibrillation are l...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/14.suppl_e.2
更新日期:1993-09-01 00:00:00
abstract::Recently, bisoprolol has been investigated regarding its effects on exercise tolerance and the duration of action in patients with coronary heart disease (CHD) following single oral administration. It appears, however, that the extent of effects of 5 mg bisoprolol is not fully established yet. Therefore, the effects o...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/eurheartj/8.suppl_m.31
更新日期:1987-12-01 00:00:00
abstract:AIMS:A new generation of multidetector-row CT (MDCT) scanners allows complete coronary coverage using retrospective ECG gating and 1mm slices. The purpose of this study was to investigate the potential of high resolution MDCT angiography with retrospective gating for detection of coronary artery stenoses. METHODS AND ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2002.3264
更新日期:2002-11-01 00:00:00
abstract:AIMS:The prognostic role of time-to-treatment in primary angioplasty is still a matter of debate. The aim of our study was to evaluate the relationship between time-to-treatment and myocardial perfusion in patients with ST-segment-elevation myocardial infarction (STEMI) treated by primary angioplasty. METHODS AND RESU...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1016/j.ehj.2004.03.021
更新日期:2004-06-01 00:00:00
abstract:Aims:Pulmonary hypertension (PH) and pulmonary vascular disease (PVD) are common and associated with adverse outcomes in heart failure with preserved ejection fraction (HFpEF). Little is known about the impact of PVD on the pathophysiology of exercise intolerance. Methods and results:Heart failure with preserved eject...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehy331
更新日期:2018-08-07 00:00:00
abstract::Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an unplanned pregnancy;...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehv141
更新日期:2015-07-14 00:00:00
abstract::Ambient air pollution is a leading cause of non-communicable disease globally. The largest proportion of deaths and morbidity due to air pollution is now known to be due to cardiovascular disorders. Several particulate and gaseous air pollutants can trigger acute events (e.g. myocardial infarction, stroke, heart failu...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehy481
更新日期:2018-10-07 00:00:00
abstract:AIMS:Homozygous familial hypercholesterolaemia (HoFH) is a rare life-threatening condition characterized by markedly elevated circulating levels of low-density lipoprotein cholesterol (LDL-C) and accelerated, premature atherosclerotic cardiovascular disease (ACVD). Given recent insights into the heterogeneity of geneti...
journal_title:European heart journal
pub_type: 共识发展会议,杂志文章
doi:10.1093/eurheartj/ehu274
更新日期:2014-08-21 00:00:00
abstract:BACKGROUND:Emerging evidence suggests that a mildly elevated body mass index (BMI), is related to improved survival and fewer cardiovascular events in patients with coronary artery disease (CAD). We hypothesize that these results are related to the poor diagnostic performance of BMI to detect adiposity, especially in t...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm243
更新日期:2007-09-01 00:00:00
abstract::During a 3-year period 2500 asymptomatic male aviators were screened routinely for coronary artery disease by maximal bicycle exercise testing. In 55 cases (2.1%) the exercise ECG was abnormal (40 subjects exhibited ST depression, 14 ventricular ectopic activity and in one subject both abnormalities were observed). Fu...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.7.766
更新日期:1991-07-01 00:00:00
abstract::The present review summarizes the available information on the effects of the three major classes of antianginal agents (nitrates, calcium and beta-blockers) on myocardial energy metabolism. It also discusses the role of some new molecules (L-carnitine, trimetazidine and ranolazine) that have been proposed as an alter...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/14.suppl_g.2
更新日期:1993-11-01 00:00:00
abstract:AIMS:The aim of this study was to determine the contribution of physical activity and abdominal obesity to the variation in inflammatory biomarkers and incident coronary heart disease (CHD) in a European population. METHODS AND RESULTS:In a prospective case-control study nested in the European Prospective Investigatio...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehp010
更新日期:2011-02-01 00:00:00
abstract:AIMS:Three methods are used to identify dysglycaemia: fasting plasma glucose (FPG), 2-h post-load plasma glucose (2hPG) from the oral glucose tolerance test (OGTT), and glycated haemoglobin A1c (HbA1c). The aim was to describe the yield and concordance of FPG, HbA1c, and 2hPG alone, or in combination, to identify dysgl...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehv008
更新日期:2015-05-14 00:00:00
abstract:AIMS:In Belgium, general practitioners (GPs) mainly manage oral anticoagulation therapy. To improve the quality of oral anticoagulation management by GPs and to compare different models and interventions, a randomized clinical trial was performed. METHODS AND RESULTS:Stratified randomization divided 66 GP-practices in...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehi327
更新日期:2005-10-01 00:00:00
abstract:AIMS:To analyse whether the proportion of patients with lone atrial fibrillation engaged in chronic sport practice was higher than that observed in the general population. METHODS AND RESULTS:The records of 1160 patients, seen at the arrhythmia outpatient clinic, were reviewed. A total of 70 patients (6%) suffered lon...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.2802
更新日期:2002-03-01 00:00:00
abstract::The study of 'atrial vulnerability' is often clinically indicated but it requires the use of invasive intracardiac stimulation. The purpose of the study was to assess the use of oesophageal pacing in the evaluation of atrial tachyarrhythmias (ATA). Fifty-five patients with documented ATA (group I) and 60 without (grou...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060632
更新日期:1994-08-01 00:00:00
abstract::Factors that exacerbate the risk of atherosclerotic plaque formation include cigarette smoking, hypertension, hypercholesterolaemia, sedentary lifestyle, and oestrogen deficiency. The potentially important role of oestrogen deficiency in this process is evidenced by the significant increase in cardiovascular risk obse...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/17.suppl_d.32
更新日期:1996-08-01 00:00:00
abstract:AIMS:Here, the aim is to assess long-term clinical variation (CV) of N-terminal pro-brain natriuretic peptide (NT-proBNP) in stable chronic heart failure (CHF) patients. The proposed use of NT-proBNP for monitoring of CHF patients will require accurate information about long-term CV of the peptide. METHODS AND RESULTS...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl449
更新日期:2007-01-01 00:00:00
abstract::A 22-year-old man who engaged in intense and regular physical exercise complained of atypical chest pain. The only remarkable abnormality found in the routine clinical work-up was a left posterior hemiblock. The echocardiogram and the magnetic resonance imaging (MRI) study showed a tumour in the posterior and superior...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060217
更新日期:1992-04-01 00:00:00
abstract:AIM:The purpose of this study was to assess the relationship between pulse pressure (PP) and cardiovascular outcomes in a large, elderly, coronary artery disease (CAD) population with hypertension, and compare the predictive power of PP with other blood pressure measures. METHODS AND RESULTS:In INternational VErapamil...
journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1093/eurheartj/ehp109
更新日期:2009-06-01 00:00:00
abstract:AIMS:Pulmonary hypertension (PH) represents an important phenotype among the broader spectrum of patients with heart failure with preserved ejection fraction (HFpEF), but its mechanistic basis remains unclear. We hypothesized that activation of endothelin and adrenomedullin, two counterregulatory pathways important in ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章
doi:10.1093/eurheartj/ehz626
更新日期:2019-12-01 00:00:00
abstract:Aims:Alcohol is a risk factor for cardiac arrhythmias. Retrospective analyses suggest supraventricular arrhythmias consecutive to acute alcohol consumption, but prospective data are limited. We intended to prospectively associate acute alcohol consumption with cardiac arrhythmias. Methods and results:At the 2015 Munic...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehx156
更新日期:2017-07-14 00:00:00
abstract::In recent years, stress echocardiography has gained broad acceptance as a non-invasive method for the diagnosis of coronary artery disease. Facing different protocols, dosages and instrumentation, official guidelines for the performance, standardization and quality control of stress echocardiograms are needed; however...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/18.suppl_d.43
更新日期:1997-06-01 00:00:00
abstract::The endothelins are a family of three widely expressed 21 amino acid peptides. Apart from the ability to constrict vascular smooth muscle, they have numerous other potent effects, from enhancing mitogenesis to influencing nervous function. The pathway of their production involves the initial synthesis of a predominant...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract:AIMS:Currently available non-invasive imaging methods frequently fail to detect alterations in left ventricular (LV) function despite histological evidence of injury. Tissue Doppler imaging (TDI) can detect subtle LV dysfunction. The aim of this study was to investigate whether TDI indices can predict LV systolic dysfu...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehl013
更新日期:2006-08-01 00:00:00
abstract::For clinical prognosis, LV function is best described in terms of ejection fraction (EF) or end-systolic volume (ESV). Because deterioration of LV function is the most important adverse prognostic factor for patients after recovery from myocardial infarction, any agent which improves function should improve long-term ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/eurheartj/11.suppl_f.5
更新日期:1990-08-01 00:00:00
abstract:AIMS:Monocytes are critical mediators of healing following acute myocardial infarction (AMI), making them an interesting target to improve myocardial repair. The purpose of this study was a gain of insight into the source and recruitment of monocytes following AMI in humans. METHODS AND RESULTS:Post-mortem tissue spec...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/eht331
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:The syndrome with an electrocardiographic pattern of right bundle branch block, ST segment elevation in leads V(1)to V(3)and sudden death is genetically determined and caused by mutations in the cardiac sodium channel. The inheritance of the disease is autosomal dominant. Sudden death may, however, occur fro...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1751
更新日期:2000-02-01 00:00:00
abstract::We conducted a survey by questionnaire to assess whether patients 'at risk' from infective endocarditis are aware of the need for good dental hygiene and antibiotic prophylaxis, and receive appropriate advice or treatment. Of 189 patients surveyed, half had told a dentist about their heart, 8% were aware of a dental p...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.6.812
更新日期:1993-06-01 00:00:00
abstract::In the interpretation of the effect of a drug or intervention in a single patient, it is desirable to know the spontaneous fluctuations of the variable under study. A few studies have determined pulmonary haemodynamic variability in acute and short-term intervals. It seems reasonable to adopt a confidence limit of 6 m...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/9.suppl_j.19
更新日期:1988-09-01 00:00:00