Chinese Herbal Medicines Might Improve the Long-Term Clinical Outcomes in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: Results of a Decision-Analytic Markov Model

Abstract

Aims. The priority of Chinese herbal medicines (CHMs) plus conventional treatment over conventional treatment alone for acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) was documented in the 5C trial (chictr.org number: ChiCTR-TRC-07000021). The study was designed to evaluate the 10-year effectiveness of CHMs plus conventional treatment versus conventional treatment alone with decision-analytic model for ACS after PCI. Methods and Results. We constructed a decision-analytic Markov model to compare additional CHMs for 6 months plus conventional treatment versus conventional treatment alone for ACS patients after PCI. Sources of data came from 5C trial and published reports. Outcomes were expressed in terms of quality-adjusted life years (QALYs). Sensitivity analyses were performed to test the robustness of the model. The model predicted that over the 10-year horizon the survival probability was 77.49% in patients with CHMs plus conventional treatment versus 77.29% in patients with conventional treatment alone. In combination with conventional treatment, 6-month CHMs might be associated with a gained 0.20% survival probability and 0.111 accumulated QALYs, respectively. Conclusions. The model suggested that treatment with CHMs, as an adjunctive therapy, in combination with conventional treatment for 6 months might improve the long-term clinical outcome in ACS patients after PCI.

Economic evaluation of deep brain stimulation compared with vagus nerve stimulation and usual care for patients with refractory epilepsy: A lifetime decision analytic model

“…A Markov decision analytic model consists of a finite number of discrete mutually exclusive "health states" that are connected by "transitions" that correspond to clinically important events, representing the disease progress, each associated with costs and outcomes (e.g., quality of life). 19 Transition probabilities express the likelihood for a patient to transit from one health state to another. 20 , 21 , 22 Based on those probabilities, costs, and effects, cost‐effectiveness can be calculated for each comparison of interventions for the desired time period.…”

Modelling the cost-effectiveness of person-centred care for patients with acute coronary syndrome

“…Previous studies on interventions for patients with ACS have mainly studied interventions pertaining to pharmaceuticals or medical procedures, not complex interventions, such as PCC. Models extrapolating results from trials designed for patients with ACS often model states such as myocardial infarction, post myocardial infarction, and post-stroke [25,27,30,32,[49][50][51]. Our model is similar to other models which extrapolate results from trials for patients with ACS except for the fact that myocardial infarction is integrated in the ACS state and, hence, is not considered a separate state in our model.…”

“…To the best of our knowledge, this is the first study in which the costeffectiveness of PCC provided to patients with ACS has been estimated for a time perspective beyond the reach of available clinical data by health-economic modelling. However, the long-term cost-effectiveness of patient-centred care has been studied, by projecting outcomes for a longer time perspective than covered by clinical data, for other therapeutic areas, for example, type 2 diabetes and heart failure [47][48][49][50].…”

Efficacy and safety of Shexiang Baoxin Pill combined with Western medicine in the treatment of acute myocardial infarction

“…[ 17 ] Beta-blockers have no short-term effect on mortality and may increase the risk of cardiogenic shock; thrombolytic agents can relieve symptoms but may also lead to stroke and massive bleeding; 10% to 18% of coronary heart disease survivors suffer from secondary myocardial infarction, stroke, or cardiovascular death after PCI. [ 18 , 19 ]…”