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[Cost-effectiveness analysis of captopril treatment after myocardial infarction]
Insights
Long-term captopril treatment significantly reduced cardiovascular mortality and morbidity in post-infarction patients with left ventricular dysfunction. This ACE inhibitor therapy is both medically effective and economically sound for high-risk individuals.
Area of Science:
- Cardiology
- Pharmacoeconomics
Background:
- Post-infarction left ventricular dysfunction poses significant cardiovascular risks.
- Early intervention is crucial for improving outcomes in high-risk cardiac patients.
Purpose of the Study:
- To evaluate the long-term efficacy and cost-effectiveness of captopril in patients with post-infarction left ventricular dysfunction.
Main Methods:
- Prospective controlled trial (SAVE) over 4 years.
- Involved over 2,000 patients with post-infarction left ventricular dysfunction.
- Compared captopril treatment with a placebo group.
Main Results:
- Captopril reduced cardiovascular mortality by 19%.
- Reduced cardiovascular morbidity and hospitalizations for heart failure and coronary events.
- Cost-effectiveness estimated at 8,750 francs per year of life saved.
Conclusions:
- Long-term captopril therapy is medically effective for high-risk post-infarction patients.
- The treatment demonstrates favorable economic soundness compared to other preventive strategies.
- Captopril offers a cost-effective solution for improving survival and reducing morbidity.
Abstract:
The recently published "Survival and Ventricular Enlargement" (SAVE), prospective controlled trial over 4 years including over 2,000 patients, has shown that long-term treatment with captopril reduced cardiovascular mortality (- 19%) and morbidity in patients with post-infarction left ventricular dysfunction without signs of cardiac failure. Based on the trial data, the extra cost of treating the patients with captopril compared with the placebo branch is estimated at 9.3 million french francs. This expense is compensated by a reduction in the cost of hospitalisation for cardiac failure of 1.6 million francs and a reduction in the cost of further coronary events of 3.4 million francs. Above all, the extra cost is compensated by a gain of 47 deaths avoided, corresponding to about 493.5 years of life saved. The cost-effectiveness of captopril administration is therefore about 8.750 francs per year per life saved. The ratio is significantly less than that of other primary or secondary prevention therapeutic strategies. On this basis, we conclude that captopril therapy of high risk post-infarction patients is a solution that is not only medically effective but also economically sound.