Implications of the Multicenter Automatic Defibrillator Implantation Trial-II
Authors: William S. Weintraub
Journal: Annals of Internal Medicine (2006)

Letters3 January 2006Implications of the Multicenter Automatic Defibrillator Implantation Trial-IIWilliam S. Weintraub, MDWilliam S. Weintraub, MDFrom Emory University, Atlanta, GA 30322.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-1-200601030-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Al-Khatib and colleagues (1) are to be commended for their evaluation of the cost-effectiveness of implantable cardioverter defibrillators (ICDs) in the Multicenter Automatic Defibrillator Implantation Trial (MADIT)-II. At 20 months, mortality was 14.2% in the ICD group and 19.8% in the controls, an absolute difference of 5.6 percentage points (2). The cost of treatment in the ICD group was estimated at $131 490 compared with $40 661 in the medical therapy group—a difference of $90 829 for a gain in life-years of 1.8 years (1). The authors found ICDs to be marginally cost-effective, with a base-case estimate of the ...References1. Al-Khatib SM, Anstrom KJ, Eisenstein EL, Peterson ED, Jollis JG, Mark DB, et al. Clinical and economic implications of the Multicenter Automatic Defibrillator Implantation Trial-II. Ann Intern Med. 2005;142:593-600. [PMID: 15838065] LinkGoogle Scholar2. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346:877-83. [PMID: 11907286] CrossrefMedlineGoogle Scholar3. Pitt B, Remme W, Zannad F, Neaton J, Martinez F, Roniker B, et al. Eplerenone, a selective aldosterone blocker, in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med. 2003;348:1309-21. [PMID: 12668699] CrossrefMedlineGoogle Scholar4. Weintraub WS, Zhang Z, Mahoney EM, Kolm P, Spertus JA, Caro J, et al. Cost-effectiveness of eplerenone compared with placebo in patients with myocardial infarction complicated by left ventricular dysfunction and heart failure. Circulation. 2005;111:1106-13. [PMID: 15723981] CrossrefMedlineGoogle Scholar5. Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R, et al. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004;351:2481-8. [PMID: 15590950] CrossrefMedlineGoogle Scholar6. Pitt B, White H, Nicolau J, Martinez F, Gheorghiade M, Aschermann M, et al. Eplerenone reduces mortality 30 days after randomization following acute myocardial infarction in patients with left ventricular systolic dysfunction and heart failure. J Am Coll Cardiol. 2005;46:425-31. [PMID: 16053953] CrossrefMedlineGoogle Scholar7. Winkelmayer WC, Cohen DJ, Berger ML, Neumann PJ. Comparing cost-utility analyses in cardiovascular medicine.. In: Weintraub WS, eds. Cardiovascular Health Care Economics. Totowa, NJ: Humana Pr; 2003:329-56. Google Scholar8. Weintraub WS, Shine K. Is a paradigm shift in US healthcare reimbursement inevitable? Circulation. 2004;109:1448-55. [PMID: 15051648] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Emory University, Atlanta, GA 30322.Disclosures: Grants received: Pfizer Inc. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClinical and Economic Implications of the Multicenter Automatic Defibrillator Implantation Trial-II Sana M. Al-Khatib , Kevin J. Anstrom , Eric L. Eisenstein , Eric D. Peterson , James G. Jollis , Daniel B. Mark , Yun Li , Christopher M. O'Connor , Linda K. Shaw , and Robert M. Califf Implications of the Multicenter Automatic Defibrillator Implantation Trial-II Fahim H. Jafary Implications of the Multicenter Automatic Defibrillator Implantation Trial-II Sana M. Al-Khatib , Daniel B. Mark , and Robert M. Califf Metrics 3 January 2006Volume 144, Issue 1Page: 65KeywordsDrug therapyHeart failureLegislationLongitudinal studiesMedicareMyocardial infarctionSudden cardiac death ePublished: 3 January 2006 Issue Published: 3 January 2006 CopyrightCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...