التفاصيل البيبلوغرافية
| العنوان: |
Treatment for Stable Coronary Artery Disease: A Network Meta-Analysis of Cost-Effectiveness Studies. |
| المؤلفون: |
Caruba, Thibaut, Katsahian, Sandrine, Schramm, Catherine, Charles Nelson, Anaïs, Durieux, Pierre, Bégué, Dominique, Juillière, Yves, Dubourg, Olivier, Danchin, Nicolas, Sabatier, Brigitte |
| المصدر: |
PLoS ONE; Jun2014, Vol. 9 Issue 6, p1-13, 13p |
| مصطلحات موضوعية: |
CORONARY heart disease treatment, COST effectiveness, FOLLOW-up studies (Medicine), MYOCARDIAL infarction, COMPARATIVE studies, META-analysis |
| مستخلص: |
Introduction and Objectives: Numerous studies have assessed cost-effectiveness of different treatment modalities for stable angina. Direct comparisons, however, are uncommon. We therefore set out to compare the efficacy and mean cost per patient after 1 and 3 years of follow-up, of the following treatments as assessed in randomized controlled trials (RCT): medical therapy (MT), percutaneous coronary intervention (PCI) without stent (PTCA), with bare-metal stent (BMS), with drug-eluting stent (DES), and elective coronary artery bypass graft (CABG). Methods: RCT comparing at least two of the five treatments and reporting clinical and cost data were identified by a systematic search. Clinical end-points were mortality and myocardial infarction (MI). The costs described in the different trials were standardized and expressed in US $ 2008, based on purchasing power parity. A network meta-analysis was used to compare costs. Results: Fifteen RCT were selected. Mortality and MI rates were similar in the five treatment groups both for 1-year and 3-year follow-up. Weighted cost per patient however differed markedly for the five treatment modalities, at both one year and three years (P<0.0001). MT was the least expensive treatment modality: US $3069 and 13 864 after one and three years of follow-up, while CABG was the most costly: US $27 003 and 28 670 after one and three years. PCI, whether with plain balloon, BMS or DES came in between, but was closer to the costs of CABG. Conclusions: Appreciable savings in health expenditures can be achieved by using MT in the management of patients with stable angina. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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