Is medical treatment for angina the most cost-effective option ?
Therapeutic issues and choices in the management of ischaemic heart disease. Symposium. New Orleans (USA), 1995/05/17.
A meta-analysis of the benefits of coronary artery bypass graft (CABG) surgery has been used as the basis of a model for comparing the costs and benefits of surgical and medical treatment of angina pectoris.
In order to allow for the results of recent research, the economic model included the addition of aspirin and aspirin plus an HMG-CoA reductase inhibitor (statin) to medical management.
The analysis indicates that in unselected patients the costeffectiveness of CABG vs initial standard medical therapy over 5 years is towards the upper limit of what can be considered a cost-effective treatment both in terms of its effect on mortality (life-years gained) and morbidity (quality adjusted life-years).
Addition of a statin to medical therapy reduced mortality and made coronary artery bypass graft surgery an expensive option in terms of improvement of quality of life.
In patients with three-vessel disease or left ventricular dysfunction surgery appears fairly cost-effective in comparison with standard medical therapy but becomes relatively expensive when the benefits of aspirin or lipid-lowering therapy are added to medical treatment.
Mots-clés Pascal : Angine poitrine, Dérivation, Aortocoronaire, Acétylsalicylique acide, Hydroxymethylglutaryl-CoA synthase, Oxo-acid-lyases, Carbon-carbon lyases, Lyases, Enzyme, Inhibiteur enzyme, Analyse avantage coût, Economie santé, Chimiothérapie, Traitement, Homme, Antiangoreux, Etude comparative, Salicylés, Inhibiteur thromboagrégation, Hypolipémiant, Appareil circulatoire pathologie, Cardiopathie coronaire, Chirurgie
Mots-clés Pascal anglais : Angina pectoris, Bypass, Aortocoronary, Acetylsalicylic acid, Hydroxymethylglutaryl-CoA synthase, Oxo-acid-lyases, Carbon-carbon lyases, Lyases, Enzyme, Enzyme inhibitor, Cost benefit analysis, Health economy, Chemotherapy, Treatment, Human, Antianginal agent, Comparative study, Salicylates, Antiplatelet agent, Antilipemic agent, Cardiovascular disease, Coronary heart disease, Surgery
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0345946
Code Inist : 002B02F03. Création : 12/09/1997.