This study examined the effect of enalapril on survival, resource use, and cost of care in patients with left ventricular dysfunction and hypertension using a retrospective analysis of patients who participated in the Studies of Left Ventricular Dysfunction (SOLVD).
Among the 6797 SOLVD participants, 1917 patients had either elevated systolic (>=140 mm Hg) or diastolic (>=90 mm Hg) blood pressure.
Therapy with enalapril was associated with a significant relative risk reduction for mortality (RR=0.819,95% CI : 0.68 to 0.98 ; P=03).
This resulted in a gain of 0.11 years (95% CI : 0.00 to 0.20 years) of survival during the average 2.8 year follow-up for this subgroup and was projected to result in a gain of 2.14 years (95% CI : 0.05 to 4.21 years) during the patient's lifetime.
Enalapril significantly reduced the risk of first hospitalization for heart failure by 37%. For all types of hospitalizations, there was an average reduction of 32 hospitalizations per 100 patients treated with enalapril during the trial period (95% CI : 11.8 to 52.2 hospitalizations avoided per 100 patients), resulting in an estimated net savings of $1656 per patient during the trial period (95% CI : increased cost of $191 to savings of $3502).
Although the projected lifetime net savings of $1456 was not significant (95% CI : increased cost of $9243 to saving of $12,527), evaluation of the cost per life year saved indicated that enalapril represented a cost-effective strategy. (...)
Mots-clés Pascal : Enalapril, Chimiothérapie, Traitement, Hypertension artérielle, Homme, Complication, Insuffisance ventriculaire gauche, Coût, Economie santé, Efficacité traitement, Long terme, Pronostic, Morbidité, Mortalité, Exploration, Ventricule cardiaque, Inhibiteur angiotensin converting enzyme, Antihypertenseur, Cardioprotecteur, Appareil circulatoire pathologie, Cardiopathie
Mots-clés Pascal anglais : Enalapril, Chemotherapy, Treatment, Hypertension, Human, Complication, Left ventricular failure, Costs, Health economy, Treatment efficiency, Long term, Prognosis, Morbidity, Mortality, Exploration, Heart ventricle, ACE inhibitor, Antihypertensive agent, Cardioprotective agent, Cardiovascular disease, Heart disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0109021
Code Inist : 002B02F05. Création : 16/11/1999.