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Cost-effectiveness of optimized adherence to prevention guidelines in European patients with coronary heart disease: Results from the EUROASPIRE IV survey

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11110%2F18%3A10381933" target="_blank" >RIV/00216208:11110/18:10381933 - isvavai.cz</a>

  • Alternative codes found

    RIV/00064190:_____/18:N0000005

  • Result on the web

    <a href="https://doi.org/10.1016/j.ijcard.2018.06.104" target="_blank" >https://doi.org/10.1016/j.ijcard.2018.06.104</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.1016/j.ijcard.2018.06.104" target="_blank" >10.1016/j.ijcard.2018.06.104</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    Cost-effectiveness of optimized adherence to prevention guidelines in European patients with coronary heart disease: Results from the EUROASPIRE IV survey

  • Original language description

    Background: This study aims to assess the cost-effectiveness of optimized guideline adherence in patients with a history of coronary heart disease. Methods: An individual-based decision tree model was developed using the SMART risk score tool which estimates the 10-year risk for recurrent vascular events in patients with manifest cardiovascular disease (CVD). Analyses were based on the EUROASPIRE IV survey. Outcomes were expressed as an incremental cost-effectiveness ratio (ICER). Results: Data from 4663 patients from 13 European countries were included in the analyses. The mean estimated 10-year risk for a recurrent vascular event decreased from 20.13% to 18.61% after optimized guideline adherence. Overall, an ICER of 52,968(sic)/QALY was calculated. The ICER lowered to 29,093(sic)/QALY when only considering high-risk patients (&gt;= 20%) with decreasing ICERs in higher risk patients. Also, a dose-response relationship was seen with lower ICERs in older patients and in those patients with higher risk reductions. A less stringent LDL target (&lt;2.5 mmol/L vs. &lt;1.8 mmol/L) lowered the ICER to 32,591(sic)/QALY and intensifying cholesterol treatment in high-risk patients (&gt;= 20%) instead of high-cholesterol patients lowered the ICER to 28,064(sic)/QALY. An alternative method, applying risk reductions to the CVD events instead of applying risk reductions to the risk factors lowered the ICER to 31,509(sic)/QALY. Conclusion: Depending on the method used better or worse ICERs were found. In addition, optimized guidelines adherence is more cost-effective in higher risk patients, in patients with higher risk reductions and when using a less strict LDL-C target. Current analyses advice to maximize guidelines adherence in particular patient subgroups.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30201 - Cardiac and Cardiovascular systems

Result continuities

  • Project

    <a href="/en/project/NV17-29520A" target="_blank" >NV17-29520A: Long term trends of CHD secondary prevention and risk prediction in selected sample of Czech population – Czech part of the EUROASPIRE V Study</a><br>

  • Continuities

    V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Others

  • Publication year

    2018

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    International Journal of Cardiology

  • ISSN

    0167-5273

  • e-ISSN

  • Volume of the periodical

    272

  • Issue of the periodical within the volume

    December

  • Country of publishing house

    NL - THE KINGDOM OF THE NETHERLANDS

  • Number of pages

    6

  • Pages from-to

    20-25

  • UT code for WoS article

    000446025200004

  • EID of the result in the Scopus database

    2-s2.0-85054124301