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Echocardiographic quantification of atherosclerosis leads to cost-effective treatment with statins

Nietlispach, Fabian and Hug, Balthasar and Jansen, Christian and Barbosa, Vânia and Keller, Dagmar and Buser, Peter T. and Siegemund, Martin and Marsch, Stephan and Hunziker, Patrick R.. (2005) Echocardiographic quantification of atherosclerosis leads to cost-effective treatment with statins. Swiss Medical Weekly, 135 (3-4). pp. 62-68.

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Official URL: http://edoc.unibas.ch/54310/

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Abstract

Objective: Use of statins in prevention of atherosclerosis is effective but expensive. Patient selection gains wider public attention as medication costs in the US and Europe augment by 8% to 10% per year. We examined different clinical risk stratification strategies, particularly focusing on echocardiographic atherosclerosis quantification, for their impact on event reduction and cost-effectiveness in statin treatment.
Methods and Results: In a prospective, consecutive cohort of 3 3 6 patients referred to non-invasive cardiac examination, risk stratification was done by various combinations of risk factors and noninvasive atherosclerosis quantification. Atherosclerotic burden was determined through measuring "aortic elastance" by transthoracic echocardiogram, a validated non-invasive method. Cardiovascular events were recorded at a mean follow-up of one year. Echocardiographically determined atherosclerosis severity and event history, especially in combination, yielded the best selection strategies for statin treatment over a broad range of predetermined funding or required event reductions, surpassing conventional cardiovascular risk factors. From 26.8 statin-preventable events/1000 patients/year (assuming all patients treated), the best selection strategies could avoid: 24 with 66% of the cost for statin treatment (atherosclerosis and age criteria), 20.1 with <50% of the budget, 12.2 with <30% of the budget or 9.6 with <15% of the budget (using combinations of atherosclerosis and prior events), while conventional strategies without echo quantification of atherosclerosis were inferior.
Conclusion: Non-invasive echocardiographic quantification of atherosclerosis improves efficiency and cost-effectiveness in statin treatment.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Anästhesiologie > Anästhesiologie (Steiner)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Anästhesiologie > Anästhesiologie (Steiner)
UniBasel Contributors:Siegemund, Martin
Item Type:Article, refereed
Publisher:EMH
ISSN:1424-7860
e-ISSN:1424-3997
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:14 Feb 2017 15:40
Deposited On:14 Feb 2017 15:40

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