Critical appraisal of costly therapy modalities for heart failure in a developing country

被引：1

作者：

Chemello D. ^{[1
]}

Goldraich L. ^{[1
]}

Alvarez J. ^{[1
]}

Beck-Da-Silva L. ^{[1
]}

Clausell N. ^{[1
]}

机构：

[1] Hospital de Clinicas de Porto Alegre, Division of Cardiology, 90035-903 Porto Alegre RS, Rua Ramiro Barcelos

来源：

Current Heart Failure Reports | 2013年 / 10卷 / 4期

关键词：

Cardiac resynchronization therapy; Chagas' disease; Heart failure management; Heart transplant; Implantable-cardioverter defibrillator; Ventricular assist devices;

D O I：

10.1007/s11897-013-0159-3

中图分类号：

学科分类号：

摘要：

Contemporaneous challenges in heart failure management include strategies to rationally use health economic resources and relative donor shortage to adequately offer electric devices (cardiac resynchronization therapy [CRT] and implantable cardioverter defibrillators [ICD]), ventricular assist devices (VADs) and heart transplant, respectively. These issues are particularly important in countries with middle-income rates and limited structured heart transplant centers, such as Brazil. Use of CRT and ICDs need to follow strict guidelines, further customized to public financial health conditions. Experience with VADs in is the early days in Brazil and will require extreme caution to allocate health public resources to develop VAD programs in highly selected centers. Chagas' disease is epidemiologically important in Brazil; outcomes of patients with Chagas' on electric devices are unclear while these patients fare better post-transplant than non-Chagas' patients. Thus, heart transplant remains an attractive option regarding both favorable outcomes and resource allocation for advanced heart failure patients in Brazil. © 2013 Springer Science+Business Media New York.

引用

页码：421 / 426

页数：5

共 44 条

[1]

Brazilian Unified Health System Database, (2013)

[2]

Paim J., Travassos C., Almeida C., Bahia L., Macinko J., The Brazilian health system: History, advances, and challenges, Lancet, 377, pp. 1778-1797, (2011)

[3]

Schmidt M.I., Duncan B.B., Azevedo Silva E G., Et al., Chronic non-communicable diseases in Brazil: Burden and current challenges, Lancet, 377, pp. 1949-1961, (2011)

[4]

Nanthakumar K., Epstein A.E., Kay G.N., Plumb V.J., Lee D.S., Prophylactic implantable cardioverter-defibrillator therapy in patients with left ventricular systolic dysfunction: A pooled analysis of 10 primary prevention trials, J Am Coll Cardiol, 44, pp. 2166-2172, (2004)

[5]

Epstein A.E., Dimarco J.P., Ellenbogen K.A., Et al., ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities, J Am Coll Cardiol, 51, pp. 1-62, (2008)

[6]

Rohde L.E., Bertoldi E.G., Goldraich L., Polanczyk C.A., Cost-effectiveness of heart failure therapies, Nat Rev Cardiol, 10, pp. 338-354, (2013)

[7]

Sanders G.D., Hlatky M.A., Owens D.K., Cost-effectiveness of implantable cardioverter-defibrillators, N Engl J Med, 353, pp. 1471-1480, (2005)

[8]

Moss A.J., Hall W.J., Cannom D.S., Et al., Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia, N Engl J Med, 335, pp. 1933-1940, (1996)

[9]

Ribeiro R.A., Stella S.F., Zimerman L.I., Pimentel M., Rohde L.E., Polanczyk C.A., Cost-effectiveness of implantable cardioverter defibrillators in Brazil in the public and private sectors, Arq Bras Cardiol, 95, pp. 577-586, (2010)

[10]

Goldenberg I., Vyas A.K., Hall W.J., Et al., Risk stratification for primary implantation of a cardioverter- defibrillator in patients with ischemic left ventricular dysfunction, J Am Coll Cardiol, 51, pp. 288-296, (2008)

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