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https://www.readbyqxmd.com/read/27909482/the-cost-effectiveness-of-laa-exclusion
#1
REVIEW
Bahij Kreidieh, Moisés Rodríguez-Mañero, Sergio H Ibarra-Cortez, Paul Schurmann, Miguel Valderrábano
Left atrial appendage (LAA) exclusion strategies are increasingly utilized for stroke prevention in lieu of oral anticoagulants. Reductions in bleeding risk and long-term compliance issues bundled with comparable stroke prevention benefits have made these interventions increasingly attractive. Unfortunately, healthcare funding remains limited. Comparative cost economic analyses are therefore critical in optimizing resource allocation. In this review we seek to discourse the cost economics analysis of LAA exclusion over available therapeutic alternatives (warfarin and the new oral anticoagulants (NOACs))...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27896982/predictive-modeling-of-hospital-readmission-rates-using-electronic-medical-record-wide-machine-learning-a-case-study-using-mount-sinai-heart-failure-cohort
#2
Khader Shameer, Kipp W Johnson, Alexandre Yahi, Riccardo Miotto, L I Li, Doran Ricks, Jebakumar Jebakaran, Patricia Kovatch, Partho P Sengupta, Sengupta Gelijns, Alan Moskovitz, Bruce Darrow, David L David, Andrew Kasarskis, Nicholas P Tatonetti, Sean Pinney, Joel T Dudley
Reduction of preventable hospital readmissions that result from chronic or acute conditions like stroke, heart failure, myocardial infarction and pneumonia remains a significant challenge for improving the outcomes and decreasing the cost of healthcare delivery in the United States. Patient readmission rates are relatively high for conditions like heart failure (HF) despite the implementation of high-quality healthcare delivery operation guidelines created by regulatory authorities. Multiple predictive models are currently available to evaluate potential 30-day readmission rates of patients...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896681/financial-impact-of-direct-acting-oral-anticoagulants-in-medicaid-budgetary-assessment-based-on-number-needed-to-treat
#3
Kathleen A Fairman, Lindsay E Davis, Courtney R Kruse, David A Sclar
BACKGROUND: Faced with rising healthcare costs, state Medicaid programs need short-term, easily calculated budgetary estimates for new drugs, accounting for medical cost offsets due to clinical advantages. OBJECTIVE: To estimate the budgetary impact of direct-acting oral anticoagulants (DOACs) compared with warfarin, an older, lower-cost vitamin K antagonist, on 12-month Medicaid expenditures for nonvalvular atrial fibrillation (NVAF) using number needed to treat (NNT)...
November 28, 2016: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/27879970/mortality-hospital-days-and-expenditures-attributable-to-ambient-air-pollution-from-particulate-matter-in-israel
#4
Gary M Ginsberg, Ehud Kaliner, Itamar Grotto
BACKGROUND: Worldwide, ambient air pollution accounts for around 3.7 million deaths annually. Measuring the burden of disease is important not just for advocacy but also is a first step towards carrying out a full cost-utility analysis in order to prioritise technological interventions that are available to reduce air pollution (and subsequent morbidity and mortality) from industrial, power generating and vehicular sources. METHODS: We calculated the average national exposure to particulate matter particles less than 2...
2016: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/27846641/prevalence-and-prognostic-implications-of-coronary-artery-calcification-in-low-risk-women-a-meta-analysis
#5
Maryam Kavousi, Chintan S Desai, Colby Ayers, Roger S Blumenthal, Matthew J Budoff, Amir-Abbas Mahabadi, M Arfan Ikram, Aad van der Lugt, Albert Hofman, Raimund Erbel, Amit Khera, Marie H Geisel, Karl-Heinz Jöckel, Nils Lehmann, Udo Hoffmann, Christopher J O'Donnell, Joseph M Massaro, Kiang Liu, Stefan Möhlenkamp, Hongyan Ning, Oscar H Franco, Philip Greenland
Importance: The role of coronary artery calcium (CAC) testing for guiding preventive strategies among women at low cardiovascular disease (CVD) risk based on the American College of Cardiology and American Heart Association CVD prevention guidelines is unclear. Objective: To assess the potential utility of CAC testing for CVD risk estimation and stratification among low-risk women. Design, Setting, and Participants: Women with 10-year atherosclerotic CVD (ASCVD) risk lower than 7...
November 22, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27846007/carotid-intima-media-thickness-as-a-cardiovascular-risk-factor-and-imaging-pathway-of-atherosclerosis
#6
Osmar Antonio Centurión
Assessment of carotid intima-media thickness (IMT) has emerged as a simple and noninvasive technique for measuring atherosclerotic burden. Although serum biomarkers have been linked to the risk of developing atherosclerosis, carotid IMT has the theoretical advantage of directly visualizing a final consequence of the disease itself, namely atherosclerosis in the vessel wall. The current widespread application of carotid IMT measurements has been based on the validity, standardization, and reproducibility of the measurement and the evidence that an increased carotid IMT can be regarded as an attractive biomarker of atherosclerosis and of increased cardiovascular risk, potentially useful as a therapeutic target in those at increased cardiovascular risk...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27822477/left-atrial-enlargement-on-transthoracic-echocardiography-predicts-left-atrial-thrombus-on-transesophageal-echocardiography-in-ischemic-stroke-patients
#7
James Anaissie, Dominique Monlezun, A Seelochan, James E Siegler, Maria Chavez-Keatts, Jonathan Tiu, Denise Pineda, Alexander George, Amir Shaban, Nidal Abi Rafeh, Laurie Schluter, Sheryl Martin-Schild, Ramy El Khoury
Background. Transesophageal echocardiogram (TEE) is superior to transthoracic echocardiogram (TTE) in detecting left atrial thrombus (LAT), a risk factor for stroke, but is costly and invasive, carrying a higher risk for complications. Aims. To determine the utility of using left atrial enlargement (LAE) on TTE to predict LAT on TEE. Methods. AIS patients who presented in 06/2008-7/2013 and underwent both TTE and TEE were identified from our prospective stroke registry. Analysis consisted of multivariate logistic regression with propensity score adjustment and receiver operating characteristic (ROC) area under the curve (AUC) analyses...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27810149/diabetes-mellitus-with-chronic-complications-in-relation-to-carotid-endarterectomy-and-carotid-artery-stenting-outcomes
#8
Oluwole Adegbala, Kimberly D Martin, David Otuada, Tomi Akinyemiju
BACKGROUND: Carotid endarterectomy and carotid artery stenting are effective treatment procedures for carotid artery stenosis. Although diabetes mellitus is highly prevalent among patients undergoing these revascularization procedures, few studies have examined their impact on periprocedural outcomes. OBJECTIVES: The study aimed to determine whether perioperative outcomes among patients undergoing carotid artery stenting and carotid endarterectomy varied depending on the presence of diabetes with or without chronic complications...
October 31, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/27771008/cost-effectiveness-of-non-vitamin-k-antagonist-oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation-at-high-risk-of-bleeding-and-normal-kidney-function
#9
Inmaculada Hernandez, Kenneth J Smith, Yuting Zhang
INTRODUCTION: The comparative cost-effectiveness of all oral anticoagulants approved up to date has not been evaluated from the US perspective. The objective of this study was to compare the cost-effectiveness of edoxaban 60mg, apixaban 5mg, dabigatran 150mg, dabigatran 110mg, rivaroxaban 20mg and warfarin in stroke prevention in atrial fibrillation patients at high-risk of bleeding (defined as HAS-BLED score≥3). MATERIALS AND METHODS: We constructed a Markov state-transition model to evaluate lifetime costs and quality-adjusted life years (QALYs) with each of the six treatments from the perspective of US third-party payers...
October 15, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/27760870/increasing-comorbidity-and-health-services-utilization-in-older-adults-with-prior-stroke
#10
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
November 15, 2016: Neurology
https://www.readbyqxmd.com/read/27756577/apixaban-was-cost-effective-vs-acenocoumarol-in-patients-with-nonvalvular-atrial-fibrillation-with-moderate-to-severe-risk-of-embolism-in-chile
#11
F Lanas, C Castro, C Vallejos, L Bustos, C de La Puente, M Velasquez, C Zaror
: Nonvalvular atrial fibrillation (NVAF) is a risk factor for ischemic stroke and systemic embolism. New oral anticoagulants are currently available. OBJECTIVE: to assess the incremental cost-utility ratio (ICUR) for apixaban versus acenocoumarol in patients treated in Chile's public health system. STUDY DESIGN AND SETTING: We assessed cost-utility from the payer perspective with a lifetime Markov model. Epidemiologic characteristics, costs, and utilities were obtained from a Chilean cohort; data were completed with information from international literature...
October 15, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27753942/os-06-07-combining-short-and-long-term-risk-scores-in-primary-prevention-of-major-cardiovascular-disease-events-in-low-incidence-populations-an-assessment-of-clinical-utility
#12
Giovanni Veronesi, Simona Giampaoli, Francesco Gianfagna, Luigi Palmieri, Diego Vanuzzo, Guido Grassi, Giancarlo Cesana, Marco M Ferrario
OBJECTIVE: To evaluate the clinical utility of the CAMUNI-MATISS 20-year risk score, recently validated for the Italian population, as additional screening tool for individuals at "low" (ESC-SCORE Project predicted 10-year risk ≤ 1%; no preventive action), "intermediate" (ESC-SCORE 1-4%; lifestyle modification/statin treatment) and "high" risk (ESC-SCORE≥ 4% or diabetes; statin treatment) according to the Italian regulation. DESIGN AND METHOD: 40-65 years old initially CVD-free participants to 7 population-based cohorts enrolled in Northern and Central Italy between 1986 and 1996 were followed-up (median 16 years, IQR: 12-20) to the first occurrence of coronary event or ischemic stroke (fatal or non-fatal), coronary or carotid revascularizations...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753831/sy-04-1-cvd-risk-prediction-in-high-risk-versus-low-risk-populations
#13
Hyeon Chang Kim
Disease risk prediction models have been developed to assess the impact of multiple risk factors and to estimate an individual's absolute disease risk. Accurate disease prediction is essential for personalized prevention, because the benefits, risks, and costs of alternative strategies must be weighed to choose the best preventive strategy for individual patients. Cardiovascular disease (CVD) prediction is the earliest example of individual risk predictions. Since the Framingham study reported a CVD risk prediction method in 1976, an increasing number of risk assessment tools have been developed to CVD risk in various settings...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27751555/validation-and-comparison-of-imaging-based-scores-for-prediction-of-early-stroke-risk-after-transient-ischaemic-attack-a-pooled-analysis-of-individual-patient-data-from-cohort-studies
#14
Peter J Kelly, Gregory W Albers, Anastasios Chatzikonstantinou, Gian Marco De Marchis, Julia Ferrari, Paul George, Mira Katan, Michael Knoflach, Jong S Kim, Linxin Li, Eun-Jae Lee, Jean-Marc Olivot, Francisco Purroy, Nicolas Raposo, Peter M Rothwell, Vijay K Sharma, Bo Song, Georgios Tsivgoulis, Cathal Walsh, Yuming Xu, Aine Merwick
BACKGROUND: Identification of patients at highest risk of early stroke after transient ischaemic attack has been improved with imaging based scores. We aimed to compare the validity and prognostic utility of imaging-based stroke risk scores in patients after transient ischaemic attack. METHODS: We did a pooled analysis of published and unpublished individual-patient data from 16 cohort studies of transient ischaemic attack done in Asia, Europe, and the USA, with early brain and vascular imaging and follow up...
November 2016: Lancet Neurology
https://www.readbyqxmd.com/read/27743468/a-monolithic-3d-0d-coupled-closed-loop-model-of-the-heart-and-the-vascular-system-experiment-based-parameter-estimation-for-patient-specific-cardiac-mechanics
#15
M Hirschvogel, M Bassilious, L Jagschies, S M Wildhirt, M W Gee
A model for patient-specific cardiac mechanics simulation is introduced, incorporating a 3-dimensional finite element model of the ventricular part of the heart which is coupled to a reduced-order 0-dimensional closed-loop vascular system, heart valve and atrial chamber model.The ventricles are modeled by a nonlinear orthotropic passive material law. The electrical activation is mimicked by a prescribed parametrized active stress acting along a generic muscle fiber orientation. Our activation function is constructed such that the start of ventricular contraction and relaxation as well as the active stress curve's slope are parameterized...
October 15, 2016: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/27684354/cost-utility-analysis-of-physician-pharmacist-collaborative-intervention-for-treating-hypertension-compared-with-usual-care
#16
Puttarin Kulchaitanaroaj, John M Brooks, Nathorn Chaiyakunapruk, Amber M Goedken, Elizabeth A Chrischilles, Barry L Carter
OBJECTIVE: To estimate long-term costs and outcomes attributable to a physician-pharmacist collaborative intervention compared with physician management alone for treating essential hypertension. METHODS: A Markov model cohort simulation with a 6-month cycle length to predict acute coronary syndrome, stroke, and heart failure throughout lifetime was performed. A cohort of 399 patients was obtained from two prospective, cluster randomized controlled clinical trials implementing physician-pharmacist collaborative interventions in community-based medical offices in the Midwest, USA...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27643337/os-06-07-combining-short-and-long-term-risk-scores-in-primary-prevention-of-major-cardiovascular-disease-events-in-low-incidence-populations-an-assessment-of-clinical-utility
#17
Giovanni Veronesi, Simona Giampaoli, Francesco Gianfagna, Luigi Palmieri, Diego Vanuzzo, Guido Grassi, Giancarlo Cesana, Marco M Ferrario
OBJECTIVE: To evaluate the clinical utility of the CAMUNI-MATISS 20-year risk score, recently validated for the Italian population, as additional screening tool for individuals at "low" (ESC-SCORE Project predicted 10-year risk ≤ 1%; no preventive action), "intermediate" (ESC-SCORE 1-4%; lifestyle modification/statin treatment) and "high" risk (ESC-SCORE≥ 4% or diabetes; statin treatment) according to the Italian regulation. DESIGN AND METHOD: 40-65 years old initially CVD-free participants to 7 population-based cohorts enrolled in Northern and Central Italy between 1986 and 1996 were followed-up (median 16 years, IQR: 12-20) to the first occurrence of coronary event or ischemic stroke (fatal or non-fatal), coronary or carotid revascularizations...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642884/sy-04-1-cvd-risk-prediction-in-high-risk-versus-low-risk-populations
#18
Hyeon Chang Kim
Disease risk prediction models have been developed to assess the impact of multiple risk factors and to estimate an individual's absolute disease risk. Accurate disease prediction is essential for personalized prevention, because the benefits, risks, and costs of alternative strategies must be weighed to choose the best preventive strategy for individual patients. Cardiovascular disease (CVD) prediction is the earliest example of individual risk predictions. Since the Framingham study reported a CVD risk prediction method in 1976, an increasing number of risk assessment tools have been developed to CVD risk in various settings...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27604455/economic-impact-of-moderate-vigorous-physical-activity-among-those-with-and-without-established-cardiovascular-disease-2012-medical-expenditure-panel%C3%A2-survey
#19
Javier Valero-Elizondo, Joseph A Salami, Chukwuemeka U Osondu, Oluseye Ogunmoroti, Alejandro Arrieta, Erica S Spatz, Adnan Younus, Jamal S Rana, Salim S Virani, Ron Blankstein, Michael J Blaha, Emir Veledar, Khurram Nasir
BACKGROUND: Physical activity (PA) has an established favorable impact on cardiovascular disease (CVD) outcomes and quality of life. In this study, we aimed to estimate the economic effect of moderate-vigorous PA on medical expenditures and utilization from a nationally representative cohort with and without CVD. METHODS AND RESULTS: The 2012 Medical Expenditure Panel Survey data were analyzed. Our study population was limited to noninstitutionalized US adults ≥18 years of age...
2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27571718/cost-effectiveness-of-implantable-cardiac-monitor-guided-intermittent-anticoagulation-for-atrial-fibrillation-an-analysis-of-the-react-com-pilot-study
#20
Daniel A Steinhaus, Peter J Zimetbaum, Rod S Passman, Peter Leong-Sit, Matthew R Reynolds
INTRODUCTION: Anticoagulation guidelines for patients with atrial fibrillation (AF) disregard AF burden. A strategy of targeted anticoagulation with novel oral anticoagulants (NOACs) based on continuous rhythm assessment with an implantable cardiac monitor (ICM) has recently been explored. We evaluated the potential cost-effectiveness of this strategy versus projected outcomes with continuous anticoagulation. METHODS AND RESULTS: We developed a Markov model using data from the Rhythm Evaluation for AntiCoagulaTion With COntinuous Monitoring (REACT...
August 30, 2016: Journal of Cardiovascular Electrophysiology
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