By Elliott M. Antman MD
This better half to Braunwald's middle sickness equips you with all of contemporary top-rated healing instructions and administration ideas for the whole diversity of middle affliction sufferers. It displays the newest criteria for drug administration in addition to the newest in new applied sciences. Reorganized to reflect your altering perform, each one cardiovascular-problem-based part deals a bankruptcy on pharmacologic remedy (with at least pathophysiology)...a bankruptcy on catheter-based or minimally invasive interventions...and a dialogue of surgical thoughts. you will additionally discover a brand-new bankruptcy on gene treatment and stem cellphone treatment, plus new chapters on many different swiftly constructing parts of perform. the result's a good single-volume resource for state of the art, clinically orientated tips on either universal and strange parts of cardiovascular treatment.
- Facilitates the decision-making technique clinicians face whilst picking out between numerous cardiovascular healing options.
- covers the most recent techniques in pathophysiology, assessment, and administration of sufferers with cardiovascular disorders
- Addresses pharmacological, interventional, and surgical administration ways for every form of heart problems, placing suggestion at the complete diversity of healing concepts at your disposal.
- Keeps you present with brand-new chapters on gene remedy and stem mobilephone remedy * volatile and protracted solid angina * administration of volatile angina and non-ST-elevation myocardial infarction * units for middle failure and arrhythmias * prevention of ischemic ailment * the regulatory approval procedure for brand spanking new cardiovascular medications and units * and extra.
- Delivers a completely revised part on "Heart Failure" that explores cardiac resynchronization remedy, surgical interventions, ambulatory administration, sanatorium administration, and cardiac transplantation and circulatory help units.
- Offers a very up-to-date part on "Other Cardiovascular stipulations" that addresses matters comparable to pharmacologic therapy of heart problems while pregnant * deal with adults with congenital center affliction * remedy of basic pulmonary high blood pressure * prevention and therapy of infective endocarditis * therapy of pericardial sickness * and rehabilitation of the sufferer with heart problems.
- Reflects a brand new emphasis at the position of vitamin and workout within the administration of cardiovascular difficulties in conformity with ACC/AHA/ESC guidance.
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Extra info for Cardiovascular Therapeutics - A Companion to Braunwald's Heart Disease: Expert Consult - Online and Print, 3e
Results of changing assumptions regarding the mortality in the “no-prevention” population without changing the proportional mortality beneﬁt of prevention. 5% in the low-risk situations. 9% population mortality rate. , in a primary prevention study). Figure 1–24 is a two-way sensitivity analysis in which the assumptions both on costs of prevention and on mortality in the no-prevention group are varied. Here, one can elaborate zones of dominance, favorable cost effectiveness, and so on. In Figure 1–24, there is a zone of dominance (to the right of 25 26 Decision-Making and Therapeutic Strategies in Cardiovascular Medicine Figure 1–21 Sensitivity analysis of altering beneﬁt assumptions (% reduction in mortality) of preventive therapy in high-risk (A) and low-risk (B) populations shown in Figure 1–19.
Here, the total cost (resource impact) of a treatment in dollars is determined in relation to its effectiveness to determine the “value” of the service. Effectiveness may be expressed in terms of years of life saved (YLS) or prolonged, where it is called CEA. 107,108 As generally applied in CEA, the cost and life expectancy (LE) or QALY for one strategy are compared with those of another “competing” strategy. For example, in comparing CABG surgery with medical therapy, one determines the entire cost (including follow-up and future events) and the LE of surgery and then subtracts the cost and the LE of drug therapy.
116 Average (or unit) costs are total costs divided by total units, whereas incremental costs are those incurred by adding one additional unit of service, such as a program or an option. For example, the hospital costs for 1000 cardiac catheterizations $ / QALY How to Read and Interpret a Meta-analysis Table 1–6 Add Night Call 150,000 Add Needed Lab 100,000 Add Redundant Lab 50,000 0 Dominant 50 100 150 200 250 300 350 400 Number of AMIs / YEAR Figure 1–16 Costs/quality-adjusted life year (QALY) of primary percutaneous transluminal coronary angioplasty (PTCA) versus thrombolysis in acute myocardial infarction (AMI), demonstrating the effect of adding emergency hospital services, hospital volume, and differences with the use of randomized clinical trials (RCTs) (efﬁcacy) versus community-based observational (effectiveness) data assumptions.