Objective: To estimate total cost of atrial fibrillation (AF) management concerning acute coronary syndrome, heart failure, stroke and drug related adverse events with respect to clinical practice and available guidelines.Methods: This cost analysis study was based on identification of total costs related to management of acute coronary syndrome, heart failure, stroke and the drug related adverse events in patients with AF based on standardized questionnaire forms filled by experts according to their daily clinical practice and also to ACCF/AHA/ESC guidelines. Total cost included cost items related to treatment, healthcare resources utilization, and diagnostic test and consultations. Results: The yearly cost of acute coronary syndrome per patient was 5.478.43 TL according to expert's view reflecting real clinical practice whereas it was 11.319.44 TL when calculation was based on recommendations in the guidelines. The average total cost of heart failure was 4.523.74 TL according to expert's view whereas it was 2.925.86 TL based on guidelines. The average total cost of stroke was 5.719.25 TL according to expert's view but 7.931.18 TL based on guidelines. Among drug related adverse events, only those related to cardiac adverse events were estimated to be higher according to expert view as compared to guideline recommendations (288.65 vs. 150.99 TL). Conclusions: Reflecting the treatment algorithms in the management of AF and related adverse events, our findings seem to emphasize the extra burden on health economics posed by patients suffering from the uncontrolled disease. (Anadolu Kardiyol Derg 2013; 13: 26-38) Key words: Atrial fibrillation, acute coronary syndrome, heart failure, stroke, adverse events, cost analysis Original Investigation Özgün Araşt›rma 26ÖZET Amaç: Atriyal fibrilasyon (AF) yönetimi toplam maliyetinin klinik uygulama ve kılavuzlar bazında hesaplanarak akut koroner sendrom, kalp yetersizliği, inme ve ilaça bağlı advers olaylar açısından maliyet verilerinin sağlanması. Yöntem: Bu maliyet analiz çalışması, AF hastalarında akut koroner sendrom, kalp yetersizliği, inme ve ilaca bağlı advers olaylar bazında toplam maliyetin, kendi klinik pratikleri ve ACCF/AHA/ESC kılavuzlarında yer alan öneriler doğrultusunda araştırıcılar tarafından doldurulan standart anket formları aracılığı ile hesaplanması yolu ile yürütüldü. Toplam tıbbi maliyet hesabına dahil edilen maliyet kalemleri tedavi, sağlık kaynakları kullanımı, tanısal testler ve konsültasyon kalemleri olarak belirlendi. Bulgular: Akut koroner sendrom için hesaplanan ortalama toplam maliyet, uzmanların günlük klinik pratiği yansıtan görüşlerine göre 5.478.43 TL iken kılavuzlar doğrultusunda 11.319.44 TL olarak hesaplandı. Kalp yetersizliği toplam maliyeti uzman görüşlerine göre 4.523.74 TL iken kılavuzlar doğrultusunda 2.925.86 TL olarak hesaplandı. İnme toplam maliyeti uzman görüşlerine göre 5.719.25 TL, kılavuzlara göre ise 7.931.18 TL olarak hesaplandı. İlaca bağlı advers olaylar içinde, yalnızca kardiyak advers olaylar için, uzman görüşl...
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