Objective: To determine the cost-effective operative strategy for coronary artery bypass surgery in patients above 70 years.
Design: Randomized, controlled trial of 900 patients above 70 years of age subjected to coronary artery bypass surgery. Patients were randomized to either on-pump or off-pump coronary artery bypass surgery. Data on direct and indirect costs were prospectively collected. Preoperatively and six months postoperatively, quality of life was assessed using EuroQol-5D questionnaires. Perioperative in-hospital costs and costs of re-intervention were included.
Results: The Summary Score of EuroQol-5D increased in both groups between preoperatively and postoperatively. In the on-pump group, it increased from 0.75 (0.16) (mean (SD)) to 0.84 (0.17), while the increase in the off-pump group was from 0.75 (0.15) to 0.84 (0.18). The difference between the groups was 0.0016 QALY and not significantly different. The mean costs were 148.940 D.Kr (CI, 130.623 D.Kr-167.252 D.Kr) for an on-pump patient and 138.693 D.Kr (CI, 123.167 D.Kr-154.220 D.Kr) for an off-pump patient. The ICER base-case point estimate was 6,829,999 D.Kr/QALY. The cost-effectiveness acceptability curve showed 89% probability of off-pump being cost-effective at a threshold value of 269,400 D.Kr/QALY.
Conclusions: Off-pump surgery tends to be more cost-effective than on-pump surgery. Long-term comparisons are warranted.
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http://dx.doi.org/10.3109/14017431.2013.781672 | DOI Listing |
J Cardiovasc Pharmacol
January 2025
Berne Cardiovascular Research Center, University of Virginia; Address: 415 Lane Road, Charlottesville, VA 22903, USA.
J Cardiovasc Pharmacol
January 2025
Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy.
Patient-reported outcome measures (PROMs) are vital tools in cardiovascular disease (CVD) research and care, providing insights that complement traditional clinical outcomes like mortality and morbidity. PROMs capture patient experiences with CVD, such as quality of life, functional capacity, and emotional well-being, allowing clinicians to assess how interventions impact daily life. PROMs are integral to cardiovascular investigations as well as management, especially in chronic conditions and rehabilitation, where they inform on the impact of personalized care plans by tracking symptom progression and patient adherence.
View Article and Find Full Text PDFAnnu Rev Pharmacol Toxicol
January 2025
Center for Cardiovascular Research, Division of Cardiology, Department of Medicine, Washington University School of Medicine, Saint Louis, Missouri, USA; email:
Although human genetics has substantial potential to illuminate novel disease pathways and facilitate drug development, identifying causal variants and deciphering their mechanisms remain challenging. We believe these challenges can be addressed, in part, by creatively repurposing the results of molecular trait genome-wide association studies (GWASs). In this review, we introduce techniques related to molecular GWASs and unconventionally apply them to understanding , a human coronary artery disease risk locus.
View Article and Find Full Text PDFDokl Biochem Biophys
January 2025
Laboratory of Microangiopathic Mechanisms of Atherogenesis, St. Petersburg State University, St. Petersburg, Russia.
The aim of this study was to describe the features of myocardial lymph flow using a new combined method of visualization of the lymphatic system. The study was performed on pig hearts harvested from a local slaughterhouse. The original dye, consisting of lipid-soluble chlorophyll and lipiodol, was injected stepwise into the lymphatic vessels.
View Article and Find Full Text PDFGen Thorac Cardiovasc Surg
January 2025
Department of Surgery & Cancer, Imperial College London, South Kensington, United Kingdom.
Introduction: Off-pump coronary artery bypass graft surgery (OPCAB) has been suggested as superior to on-pump coronary artery bypass graft surgery (ONCAB) in certain high-risk subgroups, but its benefit in patients with chronic obstructive pulmonary disease (COPD) remains controversial. This meta-analysis aimed to evaluate OPCAB versus ONCAB outcomes in COPD patients.
Methods: We followed PRISMA guidelines and searched PubMed, Embase, and the Cochrane Library in August 2024 for studies comparing OPCAB and ONCAB in COPD patients.
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