{"database":"biostudies-literature","file_versions":[],"scores":{"citationCount":0,"reanalysisCount":0,"viewCount":67,"searchCount":0},"additional":{"submitter":["Ferket BS"],"funding":["American Heart Association","NHLBI NIH HHS","National Heart, Lung, and Blood Institute"],"pagination":["2230-2240.e15"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC6960356"],"repository":["biostudies-literature"],"omics_type":["Unknown"],"volume":["159(6)"],"pubmed_abstract":["<h4>Objective</h4>The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve repair (n = 150) or coronary artery bypass grafting alone (n = 151). To address health resource use implications, we compared costs and quality-adjusted survival.<h4>Methods</h4>We used individual patient data from the Cardiothoracic Surgical Trials Network trial on survival, hospitalizations, quality of life, and US hospitalization costs to estimate cumulative costs and quality-adjusted life years. A microsimulation model was developed to extrapolate to 10 years. Bootstrap and deterministic sensitivity analyses were performed to address uncertainty.<h4>Results</h4>In-hospital costs were $59,745 for coronary artery bypass grafting plus mitral valve repair versus $51,326 for coronary artery bypass grafting alone (difference $8419; 95% uncertainty interval, 2259-18,757). Two-year costs were $81,263 versus $67,341 (difference 13,922 [2370 to 28,888]), and quality-adjusted life years were 1.35 versus 1.30 (difference 0.05; -0.04 to 0.14), resulting in an incremental cost-effectiveness ratio of $308,343/quality-adjusted life year for coronary artery bypass grafting plus mitral valve repair. At 10 years, its costs remained higher ($107,733 vs $88,583, difference 19,150 [-3866 to 56,826]) and quality-adjusted life years showed no difference (-0.92 to 0.87), with 5.08 versus 5.08. The likelihood that coronary artery bypass grafting plus mitral valve repair would be considered cost-effective at 10 years based on a cost-effectiveness threshold of $100K/quality-adjusted life year did not exceed 37%. Only when this procedure reduces the death rate by a relative 5% will the incremental cost-effectiveness ratio fall below $100K/quality-adjusted life year.<h4>Conclusions</h4>The addition of mitral valve repair to coronary artery bypass grafting for patients with moderate ischemic mitral regurgitation is unlikely to be cost-effective. Only if late mortality benefits can be demonstrated will it meet commonly used cost-effectiveness criteria."],"journal":["The Journal of thoracic and cardiovascular surgery"],"pubmed_title":["Cost-effectiveness of coronary artery bypass grafting plus mitral valve repair versus coronary artery bypass grafting alone for moderate ischemic mitral regurgitation."],"pmcid":["PMC6960356"],"funding_grant_id":["U01 HL088942","UM1 HL117924"],"pubmed_authors":["Williams M","Smith CR","Dobrev E","Miller MA","Puskas JD","Keteyian SJ","Taddei-Peters WC","Settele N","Dent JM","O'Gara PT","Kern J","Richenbacher W","Headlee M","Moskowitz AJ","Magee P","Woo A","Michler RE","Zeng X","Furie KL","Argenziano M","Jakobleff W","Pellerin M","Sellke F","Mociornita A","Nohria A","D'Alessandro DA","Yancy CW","Williams P","Corcoran PC","Hasan A","Carrier M","Trichon BH","Shavalle D","Van Patten D","Santos M","Ye X","Miller R","Neill AA","Baer J","Dang M","Malgaard H","Lala A","Yau T","Basile F","Ikonomidis JS","Walsh MN","Christakis G","Miller F","Karkhanis R","Smith RL","Kypson AP","Sai-Sudhakar C","DeRose JJ","Ferket BS","Mullen JC","Joyner C","Voisine P","Moussa F","Byington R","Prieto I","Williams JB","Cohen G","Clarke PA","O'Connor K","Young CA","Wechsler AS","Rao V","Perrault LP","Dixon DO","Dionne J","Goldfarb S","Stevens LM","Smith PK","Hampton LC","Meyer S","Acker MA","Overbey JR","Baio K","Ballivian T","Greenberg A","Chen Y","Gupta L","Romar L","Cohn L","Bowdish M","Hung JW","Weglinski M","Garrard L","Mack M","Garcia M","McDonald CL","El-Hamamsy I","Atluri P","Palumbo R","Berroteran L","Spertus J","Ailawadi G","Naka Y","Browndyke J","Fleming S","Mick SL","Dickert N","O'Sullivan K","Basmadjian AJ","Aldred H","Holubkov R","Ryan W","Moquete E","Murphy M","Kuurstra E","David T","Bonneau D","Verma S","Harris M","Burgess A","Cartier R","Bell D","Dolney D","Errett L","Berry MF","Speir AM","Giannetti N","Lackner P","Nanney T","Ralph J","Chang HL","Fecteau J","Sreekanth S","McDavid A","Horvath KA","Caulder R","Gelijns AC","Burks S","Levitan R","Bello R","Robichaud S","Javadifar S","Denault A","Brawner CA","Alexander JH","Page P","Overbey J","Cardiothoracic Surgical Trials Network Investigators","Stewart A","Pattakos G","Moody H","Bagiella E","Harrison JK","Matthews R","Williams DO","Cusimano RJ","Murkin JM","Feder-Elituv R","Sweeney DK","Akers B","Mathew JP","Johnston K","Keilani S","Aranki S","Swayze R","Jacobs A","Welsh S","Wiggers H","Parsa CJ","Shepard SA","Gardner TJ","Chase M","Chen FY","Siegenthaler MP","Sankovic K","Rose EA","Gombos IK","Lee A","Milano CA","Senechal M","Bouchard D","Chang H","Grayburn P","Gillinov AM","Roberts WC","Fredericks S","Farkouh M","Slaughter M","Fremes SE","Jeffries NO","Goldsmith L","Adams J","Desvigne-Nickens P","Thourani VH","Dussault G","Keim J","Wood C","Latter D","Spevak D","Tong BC","Moy CS","Starnes VA","Shekar P","Iraola M","Parides MK","Peterson MD","Keyte S","Shell LE","Kinn B","Kron IL","Taub C","Beach D","Woo YJ","Blackstone EH","Ad N","Bull DA","Fang JC","Nielsen SL","Haigney M","Gammie JS","Weisel R","Davidson M","Groh MA","Pinney S","Demers P","Hohmann SF","Sirois C","Ferguson TB","Guyton R","Rodriguez E","Tanguay JF","Feindel C","Goldstein DJ","Buxton D","Bolman RM","Gahring K","Hung J","Geller NL","Choy J","Solankhi N","Conboy D","Schwartz A","Noiseux N","Dagenais F","Glower DD","Leong-Poi H","Adame T","Whitman C","Kirkwood K","Couper G","Birks E","Gordon D","Mayer ML","Toulgoat-Dubois Y","Ascheim DD","O'Neal A"],"view_count":["67"],"additional_accession":[]},"is_claimable":false,"name":"Cost-effectiveness of coronary artery bypass grafting plus mitral valve repair versus coronary artery bypass grafting alone for moderate ischemic mitral regurgitation.","description":"<h4>Objective</h4>The Cardiothoracic Surgical Trials Network reported that left ventricular reverse remodeling at 2 years did not differ between patients with moderate ischemic mitral regurgitation randomized to coronary artery bypass grafting plus mitral valve repair (n = 150) or coronary artery bypass grafting alone (n = 151). To address health resource use implications, we compared costs and quality-adjusted survival.<h4>Methods</h4>We used individual patient data from the Cardiothoracic Surgical Trials Network trial on survival, hospitalizations, quality of life, and US hospitalization costs to estimate cumulative costs and quality-adjusted life years. A microsimulation model was developed to extrapolate to 10 years. Bootstrap and deterministic sensitivity analyses were performed to address uncertainty.<h4>Results</h4>In-hospital costs were $59,745 for coronary artery bypass grafting plus mitral valve repair versus $51,326 for coronary artery bypass grafting alone (difference $8419; 95% uncertainty interval, 2259-18,757). Two-year costs were $81,263 versus $67,341 (difference 13,922 [2370 to 28,888]), and quality-adjusted life years were 1.35 versus 1.30 (difference 0.05; -0.04 to 0.14), resulting in an incremental cost-effectiveness ratio of $308,343/quality-adjusted life year for coronary artery bypass grafting plus mitral valve repair. At 10 years, its costs remained higher ($107,733 vs $88,583, difference 19,150 [-3866 to 56,826]) and quality-adjusted life years showed no difference (-0.92 to 0.87), with 5.08 versus 5.08. The likelihood that coronary artery bypass grafting plus mitral valve repair would be considered cost-effective at 10 years based on a cost-effectiveness threshold of $100K/quality-adjusted life year did not exceed 37%. Only when this procedure reduces the death rate by a relative 5% will the incremental cost-effectiveness ratio fall below $100K/quality-adjusted life year.<h4>Conclusions</h4>The addition of mitral valve repair to coronary artery bypass grafting for patients with moderate ischemic mitral regurgitation is unlikely to be cost-effective. Only if late mortality benefits can be demonstrated will it meet commonly used cost-effectiveness criteria.","dates":{"release":"2020-01-01T00:00:00Z","publication":"2020 Jun","modification":"2024-11-19T23:38:48.335Z","creation":"2022-02-10T13:08:55.343Z"},"accession":"S-EPMC6960356","cross_references":{"pubmed":["31375378"],"doi":["10.1016/j.jtcvs.2019.06.040"]}}