When each device is compared incrementally , BioMonitor 2-AF dominates Reveal LINQ and Confirm RX .
BACKGROUND Cryptogenic stroke is a stroke for which no cause is identified after st and ard diagnostic tests .
Long-term implantable cardiac monitors may be better at diagnosing atrial fibrillation and provide an opportunity to reduce the risk of stroke recurrence with anticoagulants .
OBJECTIVES The objectives were to assess the diagnostic test accuracy , clinical effectiveness and cost-effectiveness of three implantable monitors [ BioMonitor 2-AF ™ ( Biotronik SE & Co. KG , Berlin , Germany ) , Confirm Rx ™ ( Abbott Laboratories , Lake Bluff , IL , USA ) and Reveal LINQ ™ ( Medtronic plc , Minneapolis , MN , USA ) ] in patients who have had a cryptogenic stroke and for whom no atrial fibrillation is detected after 24 hours of external electrocardiographic monitoring .
Cost-effectiveness of apixaban vs. current standard of care for stroke prevention in patients with atrial fibrillation
Aims Warfarin , a vitamin K antagonist ( VKA ) , has been the st and ard of care for stroke prevention in patients with atrial fibrillation ( AF ) .  Aspirin is recommended for low-risk patients and those unsuitable for warfarin . Apixaban is an oral anticoagulant that has demonstrated better efficacy than warfarin and aspirin in the ARISTOTLE and AVERROES studies , respectively , and causes less bleeding than warfarin . We evaluated the potential cost-effectiveness of apixaban against warfarin and aspirin from the perspective of the UK payer perspective . Results and methods A lifetime Markov model was developed to evaluate the pharmacoeconomic impact of apixaban compared with warfarin and aspirin in VKA suitable and VKA unsuitable patients , respectively . Clinical events considered in the model include ischaemic stroke , haemorrhagic stroke , intracranial haemorrhage , other major bleed , clinical ly relevant non-major bleed , myocardial infa rct ion , cardiovascular hospitalization and treatment discontinuations ; data from the ARISTOTLE and AVERROES trials and published mortality rates and event-related utility rates were used in the model . Apixaban was projected to increase life expectancy and quality -adjusted life years ( QALYs ) compared with warfarin and aspirin . These gains were expected to be achieved at a drug acquisition-related cost increase over lifetime . The estimated incremental cost-effectiveness ratio was £ 11 909 and £ 7196 per QALY gained with apixaban compared with warfarin and aspirin , respectively . Sensitivity analyses indicated that results were robust to a wide range of inputs . Conclusions Based on r and omized trial data , apixaban is a cost-effective alternative to warfarin and aspirin , in VKA suitable and VKA unsuitable patients with AF , respectively
When each device is compared incrementally , BioMonitor 2-AF dominates Reveal LINQ and Confirm RX .
BACKGROUND Cryptogenic stroke is a stroke for which no cause is identified after st and ard diagnostic tests .
Long-term implantable cardiac monitors may be better at diagnosing atrial fibrillation and provide an opportunity to reduce the risk of stroke recurrence with anticoagulants .
OBJECTIVES The objectives were to assess the diagnostic test accuracy , clinical effectiveness and cost-effectiveness of three implantable monitors [ BioMonitor 2-AF ™ ( Biotronik SE & Co. KG , Berlin , Germany ) , Confirm Rx ™ ( Abbott Laboratories , Lake Bluff , IL , USA ) and Reveal LINQ ™ ( Medtronic plc , Minneapolis , MN , USA ) ] in patients who have had a cryptogenic stroke and for whom no atrial fibrillation is detected after 24 hours of external electrocardiographic monitoring .