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dc.creatorLakić, Dragana
dc.creatorBogavac-Stanojević, Nataša
dc.creatorJelić-Ivanović, Zorana
dc.creatorKotur-Stevuljević, Jelena
dc.creatorSpasić, Slavica
dc.creatorKos, Mitja
dc.date.accessioned2019-09-02T11:20:08Z
dc.date.available2019-09-02T11:20:08Z
dc.date.issued2010
dc.identifier.issn1098-3015
dc.identifier.urihttps://farfar.pharmacy.bg.ac.rs/handle/123456789/1333
dc.description.abstractObjectives: Coronary artery disease (CAD), as the leading cause of death, poses a huge economic burden on health-care systems. We used a multi-marker approach to explore discriminative abilities of several lipid, inflammatory, and oxidative stress/antioxidative defense markers as CAD predictors. We assessed their cost-effectiveness compared with the Framingham risk score (FRS). Methods: Using a decision model, we evaluated the costs, accuracy, and cost-effectiveness of each model. The FRS was used as the baseline model. Other models were formed with the consecutive addition of selected markers: apolipoprotein A-I (apoA-I), apolipoprotein B (apoB), apolipoprotein (a) [apo(a)] isoform, lipoprotein (a), high-sensitivity C-reactive protein, malondialdehyde, superoxide dismutase (SOD), sulfhydryl, and superoxide anion (O-2-). A best-case model was formed from a combination of diagnostic markers to yield the best patient stratification algorithm. All models were assessed by their predictive probabilities using receiver operating characteristic curves. To accomplish our goals, we recruited 188 CAD patients (verified by coronary angiography) and 197 asymptomatic CAD-free subjects for comparison. The analysis was performed from a third-party payer perspective. Results: Only two strategies had outstanding discriminative abilities: the best-case model (FRS, SOD, and O-2-) and FRS plus SOD with area under the curve (AUC) values of 0.924 and 0.906, respectively. The cost-effectiveness ratio varied between 593 per AUC for the baseline model to 2425 per AUC for FRS plus apo(a) isoform. Strategies involving oxidative stress/antioxidative defense markers were more cost-effective than strategies involving lipid or inflammatory markers. All results were robust. Conclusion: Our results support the feasibility of a multimarker approach for CAD screening. The introduction of oxidative stress/antioxidative defense markers in the clinical laboratory would be convenient and cost-effective.en
dc.publisherElsevier Science Inc
dc.relationinfo:eu-repo/grantAgreement/MESTD/MPN2006-2010/145036/RS//
dc.rightsopenAccess
dc.sourceValue in Health
dc.subjectcoronary artery diseaseen
dc.subjectcost-effectivenessen
dc.subjectmultimarker approachen
dc.subjectrisk predictionen
dc.titleA Multimarker Approach for the Prediction of Coronary Artery Disease: Cost-Effectiveness Analysisen
dc.typearticle
dc.rights.licenseARR
dcterms.abstractЈелић-Ивановић, Зорана; Кос, Митја; Лакић, Драгана; Богавац-Станојевић, Наташа; Спасић, Славица; Котур-Стевуљевић, Јелена;
dc.citation.volume13
dc.citation.issue6
dc.citation.spage770
dc.citation.epage777
dc.citation.other13(6): 770-777
dc.citation.rankaM21
dc.identifier.wos000281666700011
dc.identifier.doi10.1111/j.1524-4733.2010.00769.x
dc.identifier.pmid20667056
dc.identifier.scopus2-s2.0-77956360726
dc.identifier.fulltexthttps://farfar.pharmacy.bg.ac.rs//bitstream/id/261/1331.pdf
dc.type.versionpublishedVersion


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