0
Summaries for Patients |

The Cost-Effectiveness of Aspirin, Statins, or Both Drugs in the Primary Prevention of Heart Disease FREE

[+] Article and Author Information

The summary below is from the full report titled “Aspirin, Statins, or Both Drugs for the Primary Prevention of Coronary Heart Disease Events in Men: A Cost–Utility Analysis.” It is in the 7 March 2006 issue of Annals of Internal Medicine (volume 144, pages 326-336). The authors are M. Pignone, S. Earnshaw, J.A. Tice, and M.J. Pletcher.


Ann Intern Med. 2006;144(5):I-29. doi:10.7326/0003-4819-144-5-200603070-00003
Text Size: A A A

What is the problem and what is known about it so far?

Heart attack occurs when blockage develops in the blood vessels that supply the heart muscle. Heart attacks are one of the most common causes of illness and are the leading cause of death in the United States. Certain conditions (“risk factors”) increase a person's chance of having a heart attack or other cardiovascular event. They include older age, male sex, high blood pressure, diabetes, smoking, high levels of total or low-density lipoprotein (“bad”) cholesterol or low levels of high-density lipoprotein (“good”) cholesterol in the blood, and close relatives who had heart attacks before 60 years of age. Aspirin decreases the chances of a heart attack in people who have had previous heart attacks (secondary prevention) and in people who have risk factors but have not yet had a heart attack (primary prevention). Statins are medications that treat high blood cholesterol levels. Many studies show that statins are effective in the primary and secondary prevention of heart attacks and other cardiovascular events. Although aspirin and statins are each known to be effective in the primary prevention of heart attacks and other cardiovascular events, the cost-effectiveness of using 1 drug, the other, or both drugs together is not known.

Why did the researchers do this particular study?

To compare the costs and benefits of using aspirin, statins, both drugs, or neither drug for the primary prevention of heart attacks and other cardiovascular events in men.

Who was studied?

Instead of studying actual patients, the researchers used computers to simulate what would happen to a group of middle-aged men with no history of heart disease who had various risk factors for experiencing a heart attack in the future.

How was the study done?

The researchers used published information to estimate what might happen (and how much it would cost) if doctors prescribed aspirin, statins, both drugs, or neither drug for middle-aged men. They put these estimates into the computer model and calculated how much longer the men would live with each treatment and how much treatment would cost for each of those additional years.

What did the researchers find?

Compared with no treatment, aspirin therapy saved years of life and costs for middle-aged men whose chance of having a heart attack or related cardiovascular event within the next 10 years was 7.5% (7.5 in 100). The addition of a statin to aspirin therapy became cost-effective if the patient's risk was 10% (10 out of 100) or greater.

What were the limitations of the study?

This study was a computer simulation. We cannot be sure what the results would be with actual patients. These estimates can be useful, however, because studies of this problem involving actual patients are unlikely to be done soon, if ever. The findings may not apply to women.

What are the implications of the study?

Middle-aged men whose chance of having a heart attack or related cardiovascular event within the next 10 years is 7.5% should consider taking aspirin for primary prevention. Men whose risk is greater than 10% should consider taking both aspirin and a statin. A tool to calculate risk of heart attack is Available at http://www.med-decisions.com.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)