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Cost-effectiveness of coronary artery bypass grafting plus mitral valve repair versus coronary artery bypass grafting alone for moderate ischemic mitral regurgitation
| Content Provider | Scilit |
|---|---|
| Author | O'Sullivan, Karen O'Gara, Patrick T. O'Neal, Allison O'Connor, Kim D'Alessandro, David A. Ferket, Bart S. Thourani, Vinod H. Voisine, Pierre Hohmann, Samuel F. Chang, Helena L. Smith, Peter K. Michler, Robert E. Ailawadi, Gorav Perrault, Louis P. Miller, Marissa A. Mick, Stephanie L. Bagiella, Emilia Acker, Michael A. Moquete, Ellen Hung, Judy W. Overbey, Jessica R. Lala, Anuradha Iraola, Margaret Gammie, James S. Gelijns, Annetine C. Moskowitz, Alan J. Taddei-Peters, Wendy C. Buxton, Dennis Caulder, Ron Geller, Nancy L. Gordon, David Jeffries, Neal O. Lee, Albert Moy, Claudia S. Gombos, Ilana Kogan Ralph, Jennifer Weisel, Richard Gardner, Timothy J. Rose, Eric A. Parides, Michael K. Ascheim, Deborah D. Chase, Melissa Chen, Yingchun Goldfarb, Seth Gupta, Lopa Kirkwood, Katherine Dobrev, Edlira Levitan, Ron Santos, Milerva Weglinski, Michael Williams, Paula Wood, Carrie Ye, Xia Nielsen, Sten Lyager Wiggers, Henrik Malgaard, Henning Mack, Michael Adame, Tracine Settele, Natalie Adams, Jenny Ryan, William Smith, Robert L. Grayburn, Paul Chen, Frederick Y. Nohria, Anju Cohn, Lawrence Shekar, Prem Aranki, Sary Couper, Gregory Davidson, Michael Bolman, R. Morton Burgess, Anne Conboy, Debra Noiseux, Nicolas Stevens, Louis-Mathieu Prieto, Ignacio Basile, Fadi Dionne, Joannie Fecteau, Julie Blackstone, Eugene H. Gillinov, A. Marc Lackner, Pamela Berroteran, Leoma Dolney, Diana Fleming, Suzanne Palumbo, Roberta Whitman, Christine Sankovic, Kathy Sweeney, Denise Kosty Pattakos, Gregory Clarke, Pamela A. Argenziano, Michael Williams, Mathew Goldsmith, Lyn Smith, Craig R. Naka, Yoshifumi Stewart, Allan Schwartz, Allan Bell, Daniel Patten, Danielle Van Sreekanth, Sowmya Alexander, John H. Milano, Carmelo A. Glower, Donald D. Mathew, Joseph P. Harrison, J. Kevin Welsh, Stacey Berry, Mark F. Parsa, Cyrus J. Tong, Betty C. Williams, Judson B. Ferguson, T. Bruce Kypson, Alan P. Rodriguez, Evelio Harris, Malissa Akers, Brenda Puskas, John D. Guyton, Robert Baer, Jefferson Baio, Kim Neill, Alexis A. Senechal, Mario Dagenais, François Dussault, Gladys Ballivian, Tatiana Keilani, Suzanne Speir, Alan M. Magee, Patrick Ad, Niv Keyte, Sally Dang, Minh Slaughter, Mark Headlee, Marsha Moody, Heather Solankhi, Naresh Birks, Emma Groh, Mark A. Shell, Leslie E. Shepard, Stephanie A. Trichon, Benjamin H. Nanney, Tracy Hampton, Lynne C. DeRose, Joseph J. Goldstein, Daniel J. Bello, Ricardo Jakobleff, William Garcia, Mario Taub, Cynthia Spevak, Daniel Swayze, Roger Basmadjian, Arsène-Joseph Bouchard, Denis Carrier, Michel Cartier, Raymond Pellerin, Michel Tanguay, Jean François El-Hamamsy, Ismail Denault, André Demers, Philippe Robichaud, Sophie Horvath, Keith A. Corcoran, Philip C. Siegenthaler, Michael P. Murphy, Mandy Greenberg, Ann Sai-Sudhakar, Chittoor Hasan, Ayseha McDavid, Asia Kinn, Bradley Pagé, Pierre Sirois, Carole Latter, David Leong-Poi, Howard Bonneau, Daniel Errett, Lee Peterson, Mark D. Verma, Subodh Feder-Elituv, Randi Cohen, Gideon Joyner, Campbell Fremes, Stephen E. Moussa, Fuad Christakis, George Karkhanis, Reena Yau, Terry Farkouh, Michael Woo, Anna Cusimano, Robert James David, Tirone Feindel, Christopher Garrard, Lisa Fredericks, Suzanne Mociornita, Amelia Mullen, John C. Choy, Jonathan Meyer, Steven Kuurstra, Emily Young, Cindi A. Beach, Dana Atluri, Pavan Woo, Y. Joseph Mayer, Mary Lou Bowdish, Michael Starnes, Vaughn A. Shavalle, David Matthews, Ray Javadifar, Shadi Romar, Linda Kron, Irving L. Johnston, Karen Dent, John M. Kern, John Keim, Jessica Burks, Sandra Gahring, Kim Bull, David A. Desvigne-Nickens, Patrice Dixon, Dennis O. Haigney, Mark Holubkov, Richard Jacobs, Alice Miller, Frank Murkin, John M. Spertus, John Wechsler, Andrew S. Sellke, Frank McDonald, Cheryl L. Byington, Robert Dickert, Neal Ikonomidis, John S. Williams, David O. Yancy, Clyde W. Fang, James C. Giannetti, Nadia Richenbacher, Wayne Rao, Vivek Furie, Karen L. Miller, Rachel Pinney, Sean Roberts, William C. Walsh, Mary N. Keteyian, Stephen J. Brawner, Clinton A. Aldred, Heather Zeng, Xin Browndyke, Jeffrey Toulgoat-Dubois, Yanne |
| Copyright Year | 2019 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery Objective The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve repair (n = 150) or coronary artery bypass grafting alone (n = 151). To address health resource use implications, we compared costs and quality-adjusted survival. Methods We used individual patient data from the Cardiothoracic Surgical Trials Network trial on survival, hospitalizations, quality of life, and US hospitalization costs to estimate cumulative costs and quality-adjusted life years. A microsimulation model was developed to extrapolate to 10 years. Bootstrap and deterministic sensitivity analyses were performed to address uncertainty. Results In-hospital costs were $59,745 for coronary artery bypass grafting plus mitral valve repair versus $51,326 for coronary artery bypass grafting alone (difference $8419; 95% uncertainty interval, 2259-18,757). Two-year costs were $81,263 versus $67,341 (difference 13,922 [2370 to 28,888]), and quality-adjusted life years were 1.35 versus 1.30 (difference 0.05; −0.04 to 0.14), resulting in an incremental cost-effectiveness ratio of $308,343/quality-adjusted life year for coronary artery bypass grafting plus mitral valve repair. At 10 years, its costs remained higher ($107,733 vs $88,583, difference 19,150 [−3866 to 56,826]) and quality-adjusted life years showed no difference (−0.92 to 0.87), with 5.08 versus 5.08. The likelihood that coronary artery bypass grafting plus mitral valve repair would be considered cost-effective at 10 years based on a cost-effectiveness threshold of $100K/quality-adjusted life year did not exceed 37%. Only when this procedure reduces the death rate by a relative 5% will the incremental cost-effectiveness ratio fall below $100K/quality-adjusted life year. Conclusions: The addition of mitral valve repair to coronary artery bypass grafting for patients with moderate ischemic mitral regurgitation is unlikely to be cost-effective. Only if late mortality benefits can be demonstrated will it meet commonly used cost-effectiveness criteria. |
| Related Links | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6960356/pdf http://www.jtcvs.org/article/S0022522319313327/pdf |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2019.06.040 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 6 |
| Volume Number | 159 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2019-07-02 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Medical Informatics Cardiothoracic Surgical Trials Network Ischemic Mitral Regurgitation Mitral Valve Mitral Valve Repair Cost-effectiveness Analysis Health Care Costs Quality-adjusted Life Years Coronary Artery Bypass Grafting Hazard Ratio Incremental Cost-effectiveness Ratio Intensive Care Unit Left Ventricular End-systolic Volume Index Mitral Regurgitation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
