Postgraduate Program in Cardiovascular Science, Universidade Federal do Rio Grande do Sul, National Institute for Health Technology Assessment (IATS), CNPq, Av. Bento Gonçalves 9500, Porto Alegre, RS, Brazil.
Nat Rev Cardiol. 2013 Jun;10(6):338-54. doi: 10.1038/nrcardio.2013.60. Epub 2013 Apr 23.
Heart failure (HF) is a leading cause of morbidity and mortality worldwide. Management of HF involves accurate diagnosis and implementation of evidence-based treatment strategies. Costs related to the care of patients with HF have increased substantially over the past 2 decades, partly owing to new medications and diagnostic tests, increased rates of hospitalization, implantation of costly novel devices and, as the disease progresses, consideration for heart transplantation, mechanical circulatory support, and end-of-life care. Not surprisingly, HF places a huge burden on health-care systems, and widespread implementation of all potentially beneficial therapies for HF could prove unrealistic for many, if not all, nations. Cost-effectiveness analyses can help to quantify the relationship between clinical outcomes and the economic implications of available therapies. This Review is a critical overview of cost-effectiveness studies on key areas of HF management, involving pharmacological and nonpharmacological clinical therapies, including device-based and surgical therapeutic strategies.
心力衰竭（HF）是全球发病率和死亡率的主要原因。HF 的管理包括准确的诊断和实施基于证据的治疗策略。在过去的 20 年中，与 HF 患者护理相关的成本大幅增加，部分原因是新的药物和诊断测试、住院率增加、昂贵的新型设备的植入以及随着疾病的进展，需要考虑心脏移植、机械循环支持和临终关怀。毫不奇怪，HF 给医疗保健系统带来了巨大的负担，如果不是所有国家，那么对许多国家来说，广泛实施所有对 HF 可能有益的治疗方法可能不切实际。成本效益分析可以帮助量化临床结果与现有治疗方法的经济影响之间的关系。这篇综述是对 HF 管理的关键领域的成本效益研究的批判性综述，涉及药物和非药物临床治疗，包括基于设备和手术的治疗策略。
