对于缺血性左心室功能障碍进行皮肤透气再血管:REVIVED-BCIS2试验的成本效益分析
Carlos Chivardi1, Holly Morgan2, Mark J Sculpher1
1Centre for Health Economics, University of York, United Kingdom (C.C., M.J.S., P.S.).
Circulation. Cardiovascular quality and outcomes
|November 6, 2023
概括
穿皮冠状动脉干预 (PCI) 对于缺血性左心室功能障碍没有证明具有成本效益,尽管最初生活质量有所改善. 该研究发现,PCI提供了类似的健康益处,但成本明显高于单独的最佳医学治疗.
科学领域:
- 心脏病学 心脏病学
- 卫生经济学 卫生经济学
背景情况:
- 穿皮冠状动脉干预 (PCI) 是常见的缺血性左心室缩功能障碍.
- REVIVED-BCIS2试验显示,PCI并没有减少死亡率或心力衰竭住院.
- 然而,与单独的最佳医疗疗 (OMT) 相比,PCI改善了最初的生活质量.
研究的目的:
- 评估PCI加OMT与单独OMT在患有缺血性左心室缩功能障碍的患者的成本效益.
主要方法:
- 英国的一项前性多中心试验随机将700名患者分配给PCI+OMT或单独OMT.
- 医疗保健资源使用和质量调整的寿命年 (QALYs) 被追踪了长达8年.
- 从英国卫生系统的角度分析了成本.
主要成果:
- 与单独的OMT相比,PCI+OMT导致了类似的QALY (4.14),但成本更高 (22,352英) (4.16 QALY,15569英).
- 增量成本效益比率仅有利于OMT.
- PCI具有成本效益的概率是可以忽略不计的.
结论:
- 与单独使用OMT相比,PCI+OMT对于缺血性左心室缩功能障碍并不具有成本效益.
- 这种情况的常规PCI不是英国医疗保健资源的合理使用.
更多相关视频
相关概念视频
Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
Cardiac Catheterization III: Left Heart Catheterization
Left heart catheterization is an invasive diagnostic procedure used to evaluate the function and structure of the left side of the heart. It is generally performed to diagnose and treat cardiovascular conditions such as valve abnormalities, coronary artery disease, and congenital heart defects.Diagnostic and therapeutic purposesLeft heart catheterization serves various diagnostic and therapeutic purposes, including:Assessing coronary artery bypass grafts.Evaluating coronary artery disease in...
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...


