PMID: 7871179Mar 1, 1995

Cost-effectiveness analysis in heart disease, Part III: Ischemia, congestive heart failure, and arrhythmias

Progress in Cardiovascular Diseases
J KupersmithJ Gardiner

Abstract

Cost-effectiveness analyses were reviewed in the following diagnostic and treatment categories: acute myocardial infarction (MI) and diagnostic strategies for coronary artery disease (CAD), coronary artery bypass graft (CABG) surgery, percutaneous transluminal coronary angioplasty (PTCA), congestive heart failure (CHF), and arrhythmias. In the case of acute MI, coronary care units, as presently used, are rather expensive but could be made much more efficient with more effective triage and resource utilization; reperfusion via thrombolysis is cost-effective, as are beta-blockers and angiotensin-converting enzyme (ACE) inhibitors post-MI in appropriate patients. Cost-effectiveness of CAD screening tests depends strongly on the prevalence of disease in the population studied. Cost-effectiveness of CABG surgery depends on targeting; eg, it is highly effective for such conditions as left-main and three-vessel disease but not for lesser disease. PTCA appears to be cost-effective in situations where there is clinical consensus for its use, eg, severe ischemia and one-vessel disease, but requires further analysis based on randomized data; coronary stents also appear to be cost-effective. In preliminary analysis, ACE inhibition for CHF ...Continue Reading

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Related Concepts

Cardiac Depressants
Coronary Artery Bypass Surgery
Cardiac Arrhythmia
Coronary Care Units
Cost Effectiveness
Myocardial Failure
Artificial Cardiac Pacemaker
Percutaneous Transluminal Coronary Angioplasty
Thrombolytic Therapy
Catheter Ablation, Transvenous

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