Cost-Effectiveness of New Cardiac and Vascular Rehabilitation Strategies for Patients with Coronary Artery Disease
Author Information
Author(s): Spronk Sandra, Bosch Johanna L., Ryjewski Constance, Rosenblum Judith, Kaandorp Guido C., White John V., Hunink M. G. Myriam
Primary Institution: Erasmus MC, Rotterdam, the Netherlands
Hypothesis
The study aims to evaluate the relative cost-effectiveness of new rehabilitation strategies that include the diagnosis and treatment of peripheral arterial disease (PAD) in patients with coronary artery disease (CAD) undergoing cardiac rehabilitation.
Conclusion
ABI measurement if cardiac rehabilitation fails followed by a diagnostic work-up and revascularization for PAD if needed are potentially cost-effective compared to cardiac rehabilitation only.
Supporting Evidence
- ABI if cardiac rehabilitation fails was the most favorable strategy with an ICER of $44,251 per QALY gained.
- A combined cardiac and vascular rehabilitation program increased the success rate and would dominate the other two strategies.
- The results were robust for different input parameters.
Takeaway
This study looked at how to help heart patients who also have leg problems. It found that checking their leg health can help them get better care.
Methodology
A Markov decision model was developed to compare three treatment strategies for cardiac rehabilitation in patients with CAD.
Potential Biases
The assumptions made in the model could introduce bias, particularly regarding the effectiveness of the rehabilitation strategies.
Limitations
The study relied on assumptions in the Markov model, which may have affected the results, and the follow-up sample size for ABI measurement was small.
Participant Demographics
The primary cohort consisted of 64-year-old male patients who entered a cardiac rehabilitation program.
Statistical Information
P-Value
0.03
Confidence Interval
95% CI: −0.17, 0.29
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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