Systematic review of economic burden of heart failure

Shafie, Asrul Akmal; Tan, Yui Ping; Ng, Chin Hui

doi:10.1007/s10741-017-9661-0

Cited by 122 publications

(116 citation statements)

References 108 publications

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“…. Projected total medical costs in 2030 will rise up $53.1 billion, and nearly 80% of these projected expenses are attributed to increased hospitalizations . All these details are mainly based on databases from national registries and insurance companies .…”

Section: Introductionmentioning

confidence: 99%

Economic impact of heart failure with preserved ejection fraction: insights from the ALDO‐DHF trial

et al. 2020

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Aims Although heart failure (HF) with preserved ejection fraction (HFpEF) is a leading cause for hospitalization, its overall costs remain unclear. Therefore, we assessed the health care-related costs of ambulatory HFpEF patients and the effect of spironolactone. Methods and resultsThe aldosterone receptor blockade in diastolic HF trial is a multicentre, prospective, randomized, double-blind, placebo-controlled trial conducted between March 2007 and April 2011 at 10 sites in Germany and Austria that included 422 ambulatory patients [mean age: 67 years (standard deviation: 8); 52% women]. All subjects suffered from chronic New York Heart Association (NYHA) class II or III HF and preserved left ventricular ejection fraction of 50% or greater. They also showed evidence of diastolic dysfunction. Patients were randomly assigned to receive 25 mg of spironolactone once daily (n = 213) or matching placebo (n = 209) with 12 months of follow-up. We used a single-patient approach to explore the resulting general cost structure and included medication, number of general practitioner and cardiologist visits, and hospitalization in both acute and rehabilitative care facilities. The average annual costs per patient in this cohort came up to €1, 118 (±2,475), and the median costs were €332. We confirmed that the main cost factor was hospitalization and spironolactone did not affect the overall costs. We identified higher HF functional class (NYHA), male patients with low haemoglobin level, with high oxygen uptake (VO 2 max) and coronary artery disease, hyperlipidaemia, and atrial fibrillation as independent predictors for higher costs. Conclusions In this relatively young, oligosymptomatic, and with regard to the protocol without major comorbidities patient cohort, the overall costs are lower than expected compared with the HFrEF population. Further investigation is needed to investigate the impact of, for example, comorbidities and their effect over a longer period of time. Simultaneously, this analysis suggests that prevention of comorbidities are necessary to reduce costs in the health care system.

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Section: Introductionmentioning

confidence: 99%

Economic impact of heart failure with preserved ejection fraction: insights from the ALDO‐DHF trial

et al. 2020

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“…Of note, HF represents a major and growing economic problem [3,11,12]. Studies particularly focused on HF economic burden are important as they contribute to a better understanding of the drivers and problems which may lead to the increasing HF costs [3].…”

Section: Introductionmentioning

confidence: 99%

“…Studies particularly focused on HF economic burden are important as they contribute to a better understanding of the drivers and problems which may lead to the increasing HF costs [3]. Increasing the knowledge about HF costs and their determinants is important in order to ascertain how HF management can be optimized, leading to a signi cant decrease of HF costs [3,7,11,12]. Unfortunately, data about costs of HF in Spain are very scarce or limited to the use of speci c drugs, but not focused on a comprehensive approach [13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Costs and Healthcare Utilisation of Patients With Heart Failure in Spain

Cervantes

Varela

Palacios³

et al. 2020

Preprint

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Background: To evaluate the cumulative costs and healthcare utilisation in heart failure (HF) patients in Spain. This was also analyzed among the DAPA-HF like population.Methods: Observational, retrospective, population-based study using BIG-PAC database, which included data from specialized and primary care of people aged ≥18 years, from 7 autonomous communities in Spain, who received care for HF between 2015 and 2019. The healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until the last year of follow-up (2019).Results: We identified 17,163 patients with HF (year 2015: mean age 77.3±11.8 years, 53.5% men, 51.7% systolic HF and 43.6% on NYHA functional class II). During the 2015-2019 period, total HF associated costs reached 15,373 Euros per person, being cardiovascular disease hospitalizations the most important determinant (75.8%), particularly HF hospitalizations (51.0%). Total medication cost accounted for 7.0% of the total cost. During this period, there was a progressive decrease of cardiovascular disease hospital costs per year (from 2,834 Euros in 2015 to 2,146 Euros in 2019, P<0.001), as well as cardiovascular and diabetic medication costs. Hospitalization and medication costs were higher in the DAPA-HF like population.Conclusions: During the 2015-2019 period, costs of patients with HF in Spain were substantial, being HF hospitalizations the most important determinant. Medication costs represented only a small proportion of total HF costs. Improving HF management, particularly through the use of those drugs that reduce HF hospitalization may be helpful to reduce HF burden.

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“…Moreover, annual costs to treat and manage HF ranges from International Dollars (Int$) 2,496.00 to Int$ 84,434.00 per patient. However, it is estimated that the in-hospital mortality ranges from 4% to 30%, and that the all-cause 1-year mortality rates among patients with acute HF and patients with chronic HF were 23.6% and 6.4%, respectively [1][2][3]. The etiology of heart failure involves coronary artery disease, rheumatic heart disease, cardiomyopathies, hyperthyroidism, and so on.…”

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confidence: 99%

Potential molecular mechanism of the NPPB gene in post-ischemic heart failure with and without T2DM

Guan

Yin

Deng

et al. 2020

Preprint

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Background This study aimed to investigate natriuretic peptide B ( NPPB ) co-expression genes and the pathways involved in post-ischemic heart failure (HF) among patients both with and without type 2 diabetes mellitus (T2DM). Methods The microarray dataset of GSE26887 was examined to detect the genes that co-expressed with NPPB from 19 post-ischemic HF patients’ peripheral blood samples (7 with T2DM and 12 without T2DM). NPPB co-expression genes were then screened using the R packet. Further, using online analytical tools, we determined the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, Gene Ontology (GO) annotation, and protein-protein interaction (PPI) network of the co-expression genes. The modules and hub genes of the PPI network were then identified using the Cytoscape software. Results In patients with T2DM, a total of 41 biological processes (BP), 20 cellular components (CC), 13 molecular functions (MF), and 41 pathways were identified. Further, a total of 61 BPs, 16 CCs, 13 MFs, and 22 pathways in patients without T2DM were identified. In both groups of patients, 17 BPs, 10 CCs, 6 MFs, and 13 pathways were enriched. We also identified 173 intersectional co-expression genes (63 positive, 106 negative, and 4 differently co-expressed in patients with and without T2DM, respectively) in both types of patients, which enriched in 16 BPs, 8 CCs, 3 MFs, and 8 KEGG pathways. Moreover, the PPI network (contained 237 edges and 170 nodes) with the top module significantly enriched in 4 BPs (the tricarboxylic acid metabolic process, citrate metabolic process, tricarboxylic acid cycle, and aerobic respiration) and 3 pathways (the citrate cycle, malaria parasite metabolic pathway, and AGE-RAGE signaling pathway in diabetic complications) was constructed. Conclusions This study used genome-wide co-expression genes to identify the potential functions and mechanisms of the NPPB gene in post-ischemic HF with and without T2DM. Our findings may elucidate the functions and roles of NPPB in patients with post-ischemic HF and facilitate HF management.

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Systematic review of economic burden of heart failure

Cited by 122 publications

References 108 publications

Economic impact of heart failure with preserved ejection fraction: insights from the ALDO‐DHF trial

Economic impact of heart failure with preserved ejection fraction: insights from the ALDO‐DHF trial

Costs and Healthcare Utilisation of Patients With Heart Failure in Spain

Potential molecular mechanism of the NPPB gene in post-ischemic heart failure with and without T2DM

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