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Cost effectiveness analysis of a cardiac rehabilitation program after an acute coronary syndrome

Session Prognosis and cost-effectiveness of cardiac rehabilitation

Speaker Ramon Andion Ogando

Event : ESC Congress 2016

  • Topic : preventive cardiology
  • Sub-topic : Outcomes
  • Session type : Moderated Posters

Authors : R Andion Ogando (Palencia,ES), E Laherran Rodriguez (Palencia,ES), EM Arias Valdes (Avila,ES), C Sanchez Del Hoyo (Palencia,ES), J Gonzalez Liebana (Palencia,ES), JM Asin Guillen (Palencia,ES)

Authors:
R. Andion Ogando1 , E. Laherran Rodriguez1 , E.M. Arias Valdes2 , C. Sanchez Del Hoyo1 , J. Gonzalez Liebana1 , J.M. Asin Guillen1 , 1Complejo Asistencial Universitario, Cardiology - Palencia - Spain , 2Hospital Nuestra Señora de Sonsoles - Avila - Spain ,

Topic(s):
Cardiovascular rehabilitation: interventions and outcomes

Citation:
European Heart Journal ( 2016 ) 37 ( Abstract Supplement ), 623

Background: Enrolment in a cardiac rehabilitation (CR) programme after an acute coronary syndrome is recommended in ESC current guidelines for the management of ST and non ST elevation acute coronary syndromes (IIa A level of recommendation). Regardless, there are important economic and social restrictions to these treatments.

Purpose: To assess a cost effectiveness analysis of a cardiac rehabilitation program after an ACS in preventing cardiovascular events and its impact in quality of life.

Methods: Retrospective analysis of all consecutive patients discharged after an ACS from a secondary hospital in Spain during 2013 and 2014. Demographic and clinical variables as well as main costs of treatment, hospitalization, were included in an Excel database for analysis. Only direct costs were taken in count as indirect costs were not available. Health care provider perspective.

Results: 226 p were included in the study; 38 of them enrolled a cardiac rehabilitation programme. Differences between groups are resumed in the table. There was no difference in myocardial infarction or death at follow up between groups. Mean follow up was 563 days. After multivariate analysis we found that patients enrolled to a cardiac rehabilitation programme were more frequently male, younger and with no peripheral arterial disease. Cost effectiveness analysis showed cardiac rehabilitation programme improve QALYs at a lower cost (dominates standard care, more effective, less costs). Incremental costs were -54294€ with a gain of 6,84 QALYs per 100 patients treated (see picture).

Conclusion: Enrolment in a cardiac rehabilitation programme after an ACS seems to be highly cost effective. People referred to these programmes are younger, mainly male, and with no peripheral artery disease. Efforts by authorities and clinicians to widespread this therapy to female and older patients should be made.

Baseline characteristics and events
Cardiac rehabilitation groupNon CR groupp
Age57.97±9.6470.85±11.87p<0.001
Female gender2p (5.2%)43p (23%)p=0.013
Peripheral arteriophaty1p (2.6%)38 p (20.2%)p<0.001
Complete revascularization32p (84.2%)117p (62.2%)p=0.009
DAPT duration9.23±4.767.52±6.38p=0.119
Myocardial infarction1p (2.6%)9p (5%)p=0.237
Angor pectoris0p (0%)6p (3.1%)p=0.014
Death0p (0%)13p (6.9%)p<0.001
Cost effectiveness

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