TY  - JOUR
A1  - Bonaventura, Klaus
A1  - Sonntag, Steffen
A1  - Kleber, Franz X.
T1  - Antiplatelet therapy in the era of percutaneous coronary intervention with drug-eluting balloons
JF  - EuroIntervention : official journal of EuroPCR and the European Association of Percutaneous Cardiovascular Interventions (EAPCI)
N2  - The high rate of restenosis associated with percutaneous coronary intervention (PCI) procedures can be reduced with the implantation of metallic stents into the stenotic vessels. The knowledge that neointimal formation can result in restenosis after stent implantation led to the development of drug-eluting stents (DES) which require long lasting antiplatelet therapy to avoid thrombotic complications. In the last years, the drug-eluting balloon (DEB) technology has emerged as an alternative option for the treatment of coronary and peripheral arteries. Clinical studies demonstrated the safety and effectiveness of DEB in various clinical scenarios and support the use of paclitaxel-eluting balloons for the treatment of in-stent restenosis, of small coronary arteries and bifurcations lesions. The protocols of DEB studies suggest that the dual antiplatelet therapy with aspirin and clopidogrel of four weeks after DEB is safe and effective.
KW  - drug-eluting balloon
KW  - clopidogrel
KW  - drug-eluting stent
KW  - coronary artery disease
Y1  - 2011
SN  - 1774-024X
VL  - 7
IS  - 2
SP  - K106
EP  - K111
PB  - Universitätsverlag Potsdam
CY  - Toulouse
ER  - 
TY  - GEN
A1  - Boldt, Julia
A1  - Leber, Alexander W.
A1  - Bonaventura, Klaus
A1  - Sohns, Christian
A1  - Stula, Martin
A1  - Huppertz, Alexander
A1  - Haverkamp, Wilhelm
A1  - Dorenkamp, Marc
T1  - Cost-effectiveness of cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary artery disease in Germany
T2  - Postprints der Universität Potsdam Humanwissenschaftliche Reihe
N2  - Background: Recent studies have demonstrated a superior diagnostic accuracy of cardiovascular magnetic resonance (CMR) for the detection of coronary artery disease (CAD). We aimed to determine the comparative cost-effectiveness of CMR versus single-photon emission computed tomography (SPECT).

Methods: Based on Bayes' theorem, a mathematical model was developed to compare the cost-effectiveness and utility of CMR with SPECT in patients with suspected CAD. Invasive coronary angiography served as the standard of reference. Effectiveness was defined as the accurate detection of CAD, and utility as the number of quality-adjusted life-years (QALYs) gained. Model input parameters were derived from the literature, and the cost analysis was conducted from a German health care payer's perspective. Extensive sensitivity analyses were performed.

Results: Reimbursement fees represented only a minor fraction of the total costs incurred by a diagnostic strategy. Increases in the prevalence of CAD were generally associated with improved cost-effectiveness and decreased costs per utility unit (Delta QALY). By comparison, CMR was consistently more cost-effective than SPECT, and showed lower costs per QALY gained. Given a CAD prevalence of 0.50, CMR was associated with total costs of (sic)6,120 for one patient correctly diagnosed as having CAD and with (sic)2,246 per Delta QALY gained versus (sic)7,065 and (sic)2,931 for SPECT, respectively. Above a threshold value of CAD prevalence of 0.60, proceeding directly to invasive angiography was the most cost-effective approach.

Conclusions: In patients with low to intermediate CAD probabilities, CMR is more cost-effective than SPECT. Moreover, lower costs per utility unit indicate a superior clinical utility of CMR.
T3  - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 551 
KW  - cost-effectiveness
KW  - cardiovascular magnetic resonance
KW  - scintigraphy
KW  - coronary angiography
KW  - coronary artery disease
Y1  - 2019
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-430107
SN  - 1866-8364
IS  - 551
ER  -