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Cost effectiveness of early discharge after uncomplicated acute myocardial infarction

Article Abstract:

Heart attack patients who are stable for up to three days after receiving thrombolytic drugs can be discharged. Thrombolytic drugs are drugs that break down blood clots, which cause most heart attacks. Researchers analyzed the cost-effectiveness of keeping patients who are stable after thrombolytic therapy for longer than three days. This analysis showed that a fourth day in the hospital would cost $105,629 per year of life saved. A fourth day might be cost-effective in patients at high risk of a complication.

Author: Newby, L. Kristin, Califf, Robert M., Topol, Eric J., Mark, Daniel B., Eisenstein, Eric L., Thompson, Trevor D., Nelson, Charlotte L., Peterson, Eric D., Armstrong, Paul W., Van de Werf, Frans, White, Harvey D.
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 2000
Reports, Cost benefit analysis, Hospital utilization, Hospital stays

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Cost effectiveness of thrombolytic therapy with tissue plasminogen activator as compared with streptokinase for acute myocardial infarction

Article Abstract:

The use of tissue plasminogen activator (t-PA) in patients with an acute heart attack appears to be cost-effective even though it is more expensive than streptokinase. Streptokinase and t-PA are thrombolytic drugs which break up the blood clots that cause heart attacks. Researchers used data from a study that compared an accelerated dose of t-PA to streptokinase to determine the cost-effectiveness of t-PA treatment. This study, called the GUSTO study, found that t-PA increased one-year survival rates by 1.1%. The cost-effectiveness of t-PA use was calculated to be $32,678 per year of life saved. This is considered to be cost-effective when compared to other medical treatments such as anti-hypertensive therapy and kidney dialysis. T-PA was considered cost-effective even though it caused a slightly increased risk of hemorrhagic stroke.

Author: Simoons, Maarten L., Califf, Robert M., Topol, Eric J., Mark, Daniel B., Nelson, Charlotte L., Armstrong, Paul W., Harrell, Frank E., Jr., Naylor, C. David, Lee, Kerry L., Hlatky, Mark A., White, Harvey, Clapp-Channing, Nancy, Barbash, Gabriel, Knight, J. David, Simes, John
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
Health aspects, Analysis, Economic aspects, Drug therapy, Medical care, Cost of, Health care costs, Tissue plasminogen activator, Thrombolytic therapy, Streptokinase

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Regional variation across the United States in the management of acute myocardial infarction

Article Abstract:

The use of heart medications and procedures to treat heart attack patients varies widely in different regions of the United States. Researchers analyzed data from a national study on the treatment of acute myocardial infarction in 21,772 patients. New England had the greatest percentage of patients who received oral beta-blockers, ACE inhibitors, and nitrates, and the lowest percentage of patients who received calcium-channel blockers and digitalis. Cardiac procedures such as angiography, angioplasty, and bypass surgery were performed least often in New England and most often in central regions. The use of cardiac procedures was directly related to their availability, except in New England where use was considerably lower than availability. Physicians in New England, more than those in other regions, tended to prescribe drugs with proven benefits.

Author: Ohman, E. Magnus, Califf, Robert M., Topol, Eric J., Mark, Daniel B., Armstrong, Paul W., Gore, Joel M., Weaver, W. Douglas, Miller, Dave P., Pilote, Louise, Sapp, Shelly
Publisher: Massachusetts Medical Society
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1995
Medical care, Practice, Demographic aspects, Cardiology

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Subjects list: Care and treatment, Heart attack
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