Asymptomatic XXXX : is pharmacological prevention of cardiovascular risk cost-effective?

@entity1 @entity1289 @entity3657 @entity1397 @entity117 @entity1780 @entity65
@entity3657 ( @entity3657 ) is associated with an increased risk of early @entity65 . The majority of @entity3657 subjects are asymptomatic with a prevalence of 11 per cent among the elderly. Long-term drug prevention aiming to minimize disease progression and CV events in these subjects is probably beneficial, but expensive. The purpose of this analysis was to evaluate the cost-effectiveness of pharmacological risk reduction in subclinical @entity3657 . Long-term costs and quality-adjusted life years (QALYs) were estimated by employing a decision-analytic model for @entity1289 -inhibitor, @entity1780 , @entity117 and non- @entity117 anti-platelet therapy. Rates of CV events without treatment were derived from epidemiological studies and event rate reduction were retrieved from clinical trials. Costs and health-related quality of life estimates were obtained from published sources. All four drugs reduced CV events. Using @entity1289 -inhibition resulted in a heart rate (HR) of 0.67 (95% CI: 0.55-0.79), statins 0.74 (0.70-0.79), and @entity1397 0.72 (0.43-1.00). @entity117 had a HR of 0.87 and the 95% CI passed included one (0.72-1.03). @entity1289 -inhibition was associated with the largest reduction in events leading to the highest gain in QALYs (7.95). Furthermore, @entity1289 -inhibitors were associated with the lowest mean cost    40.556. In conclusion, while all drugs reduced CV events, @entity1289 -inhibition was the most cost-effective. These results suggest that we should consider efforts to identify @entity1 with asymptomatic @entity3657 and, when identified, offer @entity1289 -inhibition.
