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

Kód výsledku v 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>

Nalezeny alternativní kódy

RIV/00064190:_____/18:N0000005

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

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

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

<a href="/cs/project/NV17-29520A" target="_blank" >NV17-29520A: Dlouhodobé trendy sekundární prevence ICHS a predikce rizika ve vybraném vzorku české populace - česká část studie EURASPIRE V</a><br>

Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2018

Kód důvěrnosti údajů

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

Název periodika

International Journal of Cardiology

ISSN

0167-5273

e-ISSN

—

Svazek periodika

272

Číslo periodika v rámci svazku

December

Stát vydavatele periodika

NL - Nizozemsko

Počet stran výsledku

6

Strana od-do

20-25

Kód UT WoS článku

000446025200004

EID výsledku v databázi Scopus

2-s2.0-85054124301