Scroll Up
Scroll Down
Play Play Play Play
Unregistered User
Click here if this is not your Personal Edition
 
Contact Us | Free E-Mail Updates | Journals | Register a colleague
 
 
Angina Pectoris/MI
 
   
 
SEARCH   
Doctor's Guide Free CME
Medline
Congress Resource Centre
 

 EXPLORE :
   Most Read News
 All News  All News
 All Webcasts / CME  All Webcasts / CME
 All Cases  All Cases
 Congress Resource Centre  Congress Resource Centre
 All Medical Resources  All Medical Resources
 Medical  My Personal Edition



Warning | Privacy

 

 
 Recent news - Angina Pectoris/MI
    Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis - (JAMA)
    Invasive Treatment Appears Beneficial for Men and High-Risk Women With Certain Coronary Syndromes - (DGNews)
    Outcomes following coronary stenting in the era of bare-metal vs the era of drug-eluting stents - (JAMA)
    New Guidance Available for Cardiologists Treating Myocardial Bridging - (DGNews)
    TopAbstracts in Angina Pectoris/MI 06/25/2008 - (DGNews)

    News archive

     Recent webcasts/CME - Angina Pectoris/MI
      Optimizing Antiplatelet Therapy in the ACS Patient: The Intersection of Acute Coronary Syndromes and Oral Antiplatelet Therapy
      Use of Direct Thrombin Inhibitors for Treating Non-St-Segment Elevation Acute Coronary Syndromes in Special Patient Groups: Women, Diabetics, the Elderly, and Chronic Renal Insufficiency
      CRUSADE: Contemporary Evaluation and Management of 200,000 High-Risk NSTE-ACS Patients
      Understanding Chronic Ischemic Heart Disease Today
      Risk Stratification in Patients with Chronic Myocardial Ischemia

      Webcasts/CME archive

       Recent cases - Angina Pectoris/MI
        Diagnostic Uncertainty of Takotusbo Cardiomyopathy Presenting as Acute Myocardial Infarction in a Woman with Cardiovascular Risk Factors Hijacked at Gunpoint: A Case Report
        The Role of Intravascular Ultrasound in the Management of Spontaneous Coronary Artery Dissection
        Unusual Cause of Exercise-Induced Ventricular Fibrillation in a Well-Trained Adult Endurance Athlete: A Case Report
        Myocardial Ischemia in the Absence of Epicardial Coronary Artery Disease in Friedreich's Ataxia
        Double Rupture of Interventricular Septum and Free Wall of the Left Ventricle, as a Mechanical Complication of Acute Myocardial Infarction: A Case Report

        Cases archive
          




        my personal edition > angina pectoris/mi > news
        divider

          E-Mail this DGDispatch to a colleague

        DGDispatch


        Eplerenone is Cost-Effective for Patients with Heart Failure After a Myocardial Infarction: Presented at ACC

        By Jill Stein

        NEW ORLEANS, LA -- March 9, 2004 -- New findings indicate that selective aldosterone blockade with eplerenone post-myocardial infarction (MI) in patients with heart failure prevents cardiovascular events and prolongs life at a cost that is acceptable according to standard benchmarks.

        Dr. William S. Weintraub, with Emory University in Atlanta, Georgia, reported the data here on March 8th at the American College of Cardiology 53rd Annual Scientific Session. The goal of the study was to determine the cost-effectiveness of eplerenone based on the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS).

        The EPHESUS study evaluated the co-primary end points of total mortality and cardiovascular (CV) mortality/CV hospitalization in 6,632 post-MI patients with systolic left ventricular dysfunction and symptoms of heart failure. Treatment involved eplerenone 25 mg titrated to 50 mg QD or placebo in addition to standard therapy and patients were followed for a mean of 16 months.

        Results showed that eplerenone reduced total mortality by 15% (P = .008) and cardiovascular mortality/hospitalization by 13% (P = .002).

        The analysis aimed to compare the total costs incurred from randomization through the end of follow-up between the eplerenone and placebo treatment arms. Also, if the eplerenone arm was found to be both more costly and more effective than placebo, the investigators then aimed to determine the incremental cost-effectiveness of the addition of eplerenone in the management of heart failure complicating acute MI.

        Trial wide efficacy and resource use were assessed. Unit costs in multiple countries were applied to hospitalizations and emergency room visits by diagnosis-related groups and outpatient procedures. Medication use was costed using average wholesale price. Initial hospitalization costs were not included in the base case as the study drug was initiated towards the end of this hospitalization period.

        Results showed that there was no significant difference between the treatment groups for the cost in any category of examined healthcare resource use. In fact, the costs of the initial hospitalization, rehospitalization and emergency room visits during follow-up were lower for patients treated with eplerenone, whereas medication costs and outpatient procedure costs during follow-up were higher for eplerenone patients.

        The costs of CV rehospitalizations and heart failure rehospitalizations were lower among patients treated with eplerenone versus those treated with placebo. For heart failure reshospitalizations, the difference was statistically significant.

        Eplerenone provided a significant advantage over placebo for in-trial life-years (1.33 years for eplerenone and 1.30 years for placebo patients) and for lost life expectancy when life expectancy was calculated using published Framingham data (0.5390 and 0.6404 for the 2 groups, respectively).

        Overall, independently of drug costs, aldosterone blockade with eplerenone in the setting of heart failure post-MI is a dominant strategy that can prevent events, prolong life and reduce resource use without increasing cost, Dr. Weintraub said.


        [Study title: Cost-Effectiveness of Eplerenone in Patients With Heart Failure Postmyocardial Infarction. Abstract 1108-122]



        E-Mail this DGDispatch to a colleague   To print, use this version






        All contents Copyright (c) 1995-2008 Doctor's Guide Publishing Limited. All rights reserved.



        The NTK initiative. Physicians helping physicians identify Need-To-Know science
           Feedback
        Please rate this article: Strongly DISAGREE...Strongly AGREE NTK logo
        Question 1 - Physicians need to become aware of this information as soon as possible. Question 2 - This information is likely to have an impact on the way physicians practice medicine.
        1
        2
        3
        4
        5
        6
        7
        Send