| Autor: |
Sloth, Astrid D, Schmidt, Michael R, Munk, Kim, Schmidt, Morten, Pedersen, Lars, Sørensen, Henrik T, Enemark, Ulrika, Parner, Erik T, Bøtker, Hans Erik, Bøttcher, M, Kaltoft, AK, Terkelsen, CJ, Andersen, NH, Hansen, TM, Trautner, S, Lassen, JF, Christiansen, EH, Krusell, LR, Kristensen, SD, Thuesen, L, Nielsen, SS, Rehling, M, Nielsen, TT |
| Zdroj: |
European Heart Journal : Acute Cardiovascular Care; April 2017, Vol. 6 Issue: 3 p244-253, 10p |
| Abstrakt: |
Aims: Remote ischaemic conditioning seems to improve long-term clinical outcomes in patients undergoing primary percutaneous coronary intervention. Remote ischaemic conditioning can be applied with cycles of alternating inflation and deflation of a blood-pressure cuff. We evaluated the cost-effectiveness of remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction from the perspective of the Danish healthcare system.Methods and results: Between February 2007 and November 2008, 251 patients with ST-elevation myocardial infarction were randomly assigned to remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention (n=126) or to primary percutaneous coronary intervention alone (n=125). During a 4-year follow-up period, we used data from Danish medical registries and medical records to estimate within-trial cardiovascular medical care costs and major adverse cardiac and cerebrovascular event-free survival. After 4 years of follow-up, mean cumulative cardiovascular medical care costs were €2763 (95% confidence interval 207–5318, P=0.034) lower in the remote ischaemic conditioning group than in the control group (€12,065 vs. €14,828), while mean major adverse cardiac and cerebrovascular event-free survival time was 0.30 years (95% confidence interval 0.03–0.57, P=0.032) higher in the remote ischaemic conditioning group than in the control group (3.51 vs. 3.21 years). In the cost-effectiveness plane, remote ischaemic conditioning therapy was economically dominant (less costly and more effective) in 97.26% of 10,000 bootstrap replications.Conclusion: Remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention appears to be a cost-effective treatment strategy in patients with ST-elevation myocardial infarction. |
| Databáze: |
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