[翻译文章]西班牙萨库比特里尔/瓦尔萨坦在心力衰竭中降低射出分数的成本效益
Antonio García-Quintana1, Héctor Alonso Ramos2, Javier Parrondo3
1Servicio de Cardiología, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria, Spain.
概括
在心力衰竭患者的医院中开始使用sacubitril/ valsartan是具有成本效益的. 与埃纳拉普利尔相比,这种新疗法改善了寿命和质量调整寿命,为西班牙国家卫生服务提供了价值.
科学领域:
- 药物经济学
- 心脏病学
- 医疗服务研究
背景情况:
- 心力衰竭 (HF) 是一种普遍的疾病,医疗费用很高,经常导致住院治疗.
- 在西班牙,HF是出院诊断的主要原因,突显了严重的公共卫生负担.
研究的目的:
- 评估sacubitril/valsartan的经济影响,这是一种心力衰竭的新疗法.
- 为了比较在住院期间启动sacubitril/ valsartan与出院后的成本效益,使用enalapril作为比较剂.
主要方法:
- 一个马尔科夫模型被开发用于经济评估.
- 使用了PARADIGM- HF和PIONEER- HF研究的数据.
- 分析的关键指标包括总成本,增长寿命年 (LYG),质量调整寿命年 (QALYs) 和增量成本效益/效用比率 (ICER/ICUR).
主要成果:
- 与埃纳拉普利尔相比,萨库比特/ 瓦尔沙坦的LYG和QALY有所改善.
- 增加的成本效益比 (ICUR) 低于20,000欧元/QALY.
- 在住院后开始使用sacubitril/ valsartan,可获得更有利的ICUR.
结论:
- 在心力衰竭住院期间开始使用sacubitril/ valsartan是一种成本有效的策略.
- 从西班牙国家卫生服务的角度来看,这种方法被认为是具有成本效益的.
更多相关视频
06:10Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
3.4K
07:39Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
Published on: August 16, 2021
3.7K
相关概念视频
01:30Heart Failure V: Medical Management
23
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
23
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
505
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
505
01:22Heart Failure Drugs: Diuretics
483
Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
483
01:22Heart Failure Drugs: β-Blockers
434
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
434
01:22Heart Failure VI: Adjunct Therapies
27
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
27
01:30Heart Failure IV: Classification and Diagnostic Evaluation
32
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
32