This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (65)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Review  • Congestive Heart Failure/ Cardiomyopathy  • Alert me on articles by topic

The Case of Heart Failure

Michael W. Rich, MD; Robert F. Nease, PhD

Arch Intern Med. 1999;159:1690-1700.

Heart failure is the leading cause of hospitalization in adults older than 65 years, and it is currently the most costly cardiovascular disorder in the United States, with estimated annual expenditures in excess of $20 billion. Recent studies have shown that selected pharmacological agents, behavioral interventions, and surgical therapies are associated with improved clinical outcomes in patients with heart failure, but the cost implications of these diverse treatment modalities are not widely appreciated. In this review, a brief outline of cost-effectiveness analysis is provided, and current data on the cost-effectiveness of specific approaches to managing heart failure are discussed. Available evidence indicates that angiotensin converting enzyme inhibitors, other vasodilators, digoxin, carvedilol, multidisciplinary heart failure management teams, and heart transplantation are all cost-effective approaches to treating heart failure; moreover, some of these interventions may result in net cost savings.

From the Geriatric Cardiology Program and the Division of General Medical Sciences, Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, Mo.

RELATED ARTICLE

Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 1999;159(15):1818-1819.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Increasing the involvement of specialist physicians in chronic disease management
Taylor and Lahey
J Health Serv Res Policy 2008;13:52-56.
ABSTRACT | FULL TEXT  

Impact of intracoronary bone marrow cell transfer on diastolic function in patients after acute myocardial infarction: results from the BOOST trial
Schaefer et al.
Eur Heart J 2006;27:929-935.
ABSTRACT | FULL TEXT  

Does This Dyspneic Patient in the Emergency Department Have Congestive Heart Failure?
Wang et al.
JAMA 2005;294:1944-1956.
ABSTRACT | FULL TEXT  

Use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure
Zuccala et al.
Eur Heart J 2005;26:226-233.
ABSTRACT | FULL TEXT  

Heart Failure Management: Caregiver Versus Care Plan
Kim and Hunt
Circulation 2003;108:129-131.
FULL TEXT  

Nitroxyl gets to the heart of the matter
Feelisch
Proc. Natl. Acad. Sci. USA 2003;100:4978-4980.
FULL TEXT  

Nesiritide: A Novel Approach for Acute Heart Failure
Vichiendilokkul et al.
The Annals of Pharmacotherapy 2003;37:247-258.
ABSTRACT | FULL TEXT  

Depression-Related Costs in Heart Failure Care
Sullivan et al.
Arch Intern Med 2002;162:1860-1866.
ABSTRACT | FULL TEXT  

Effect of nesiritide versus dobutamine on short-term outcomes in the treatment of patients with acutely decompensated heart failure
Silver et al.
J Am Coll Cardiol 2002;39:798-803.
ABSTRACT | FULL TEXT  

Hypotension and cognitive impairment: Selective association in patients with heart failure
Zuccala et al.
Neurology 2001;57:1986-1992.
ABSTRACT | FULL TEXT  

Heart Failure in the 21st Century: A Cardiogeriatric Syndrome
Rich
J. Gerontol. A Biol. Sci. Med. Sci. 2001;56:88M-96.
ABSTRACT | FULL TEXT  

Cognitive dysfunction as a major determinant of disability in patients with heart failure: results from a multicentre survey
Zuccala et al.
J. Neurol. Neurosurg. Psychiatry 2001;70:109-112.
ABSTRACT | FULL TEXT  

AHA Scientific Statement: AHA Dietary Guidelines: Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Krauss et al.
J. Nutr. 2001;131:132-146.
FULL TEXT  

AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Krauss et al.
Stroke 2000;31:2751-2766.
FULL TEXT  

AHA Dietary Guidelines : Revision 2000: A Statement for Healthcare Professionals From the Nutrition Committee of the American Heart Association
Krauss et al.
Circulation 2000;102:2284-2299.
FULL TEXT  

Congestive Heart Failure: Who Should Provide Care?
Morris and Petruccelli
ANN INTERN MED 2000;132:238-239.
FULL TEXT