| Treatment Duration (Most Relevant) |
|---|
| Arbel Y35 | 2018 | Canada | Patients undergoing PCI | DAPT 3 to 6 months versus DAPT 12 months versus DAPT 30 to 36 months | Markov patient-level simulation (lifetime horizon in 63-year-old individuals, 1-month cycles) | Efficacy populated by NMA (stable angina and ACS patients) Markov states:
bleeding death MI PCI stent thrombosis stroke
|
| Garg P38 | 2015 | US | Patients undergoing PCI with DES | DAPT (clopidogrel + ASA) 6 months versus DAPT 12 months versus DAPT 30 months | Markov cohort (lifetime) to identify threshold of benefits to outweigh harms; sensitivity analysis on ACS (12 months and 18 months, only) and non-ACS patients | Markov states:
|
| Jiang M42 | 2017 | US | ACS patients who had DAPT for 12 months after PCI (DES) | ASA 75mg to 162 mg + clopidogrel for 12 months versus further DAPT (ASA + clopidogrel) for 18 months post-PCI | Markov (lifetime in 60-year-old individuals) | Markov states:
bleeding (major) death (CV) MI (non-fatal) stent thrombosis stroke (non-fatal)
|
| DAPT Versus ASA |
|---|
| Beinart SC36 | 2005 | US (using results from multinational CREDO trial) | Patients with coronary artery disease undergoing PCI | Clopidogrel 75 mg + ASA daily for 1 year versus Clopidrogrel 75 mg daily for 28 days + ASA daily for 1 year | Decision tree (lifetime horizon) | Using:
Health care resources and clinical events collected during the trial: major CV health care-related resources for death, bleeding, MI, stroke; revascularization procedures; in- and outpatient medications (all other ambulatory care excluded) Framingham Heart Study and Swedish database for long-term survival
|
| Kolm P44 | 2007 | Canada | ACS | Clopidogrel + ASA versus ASA + placebo for 1 year (CURE study) (PCI-CURE: subset who had a PCI) | Decision tree (1 year) | Health care resources from CURE trial Clinical events: bleeding, death, MI, stroke |
| Lindgren P45 | 2005 | Sweden | Unstable angina undergoing PCI (PCI-CURE study) | ASA + placebo versus ASA + clopidogrel for 1 year | Markov | Markov states:
death (CV) death (other causes) MI year 1 MI subsequent years
|
| Mahoney EM46 | 2006 | US | ACS without ST-segment elevation undergoing PCI (PCI-CURE patient-level data) | ASA versus ASA + clopidogrel for up to 1 year | Decision tree | Hospitalizations and treatment taken from PCI-CURE study; assigned DRG post-hoc; costs per DRG from Medicare and/or MEDSTAT for trial duration; long-term costs and survival from Saskatchewan health care database Clinical events: bleeding, death, MI, stroke |
| Ringborg A51 | 2005 | Sweden | Patients undergoing PCI | Clopidogrel for 28 days + ASA for 12 months versus clopidogrel + ASA for 12 months | Markov | Using CREDO trial results; Markov states:
death MI year 1 MI subsequent years stroke year 1 stroke subsequent years
|
| Zhang Z53 | 2009 | US | Patients presenting at ER with suspected MI and STEMI within 24 hours undergoing PCI (COMMIT) | Clopidogrel 75 mg versus clopidogrel + ASA 162 mg for 1 year | Decision tree | Using COMMIT trial for 28-day outcomes, long-term outcomes assumed to be similar to CURE trial; Outcomes:
bleeding (major) CABG death ischemia (refractory) MI complication PCI stroke
|
| P2Y12 Drugs in DAPT |
|---|
| Davies A37 | 2013 | Germany, Sweden, Netherlands, Turkey (using results of the TRITON-TIMI trial) | ACS patients undergoing PCI | Prasugrel + ASA versus clopidrogrel + ASA for 1 year | Markov patient-level simulation (40-year horizon; 12 monthly cycles; risk equations derived from TRITON-TIMI trial) | Markov states:
3-day acute phase bleeds (major, minor) death (CV) MI (non-fatal) stroke (non-fatal)
Using theTRITON-TIMI trial;restricted to 1 primary event and 1 bleed event per patient;
risks are implemented in 2 stages:
Same process for bleedsNo event beyond 12 months is modelled but lifetime related costs (e.g., ischemic events) are accounted for |
| Gasche D39 | 2013 | Switzerland | ACS patients (including stent installation in 60%) | Ticagrelor + ASA versus generic clopidrogrel + ASA for 1 year | 1 year decision tree and lifetime Markov model (original model developed by Nikolic et al.49) | Using:
|
| Greenhalgh J40 | 2015 | UK (NICE TA182) | ACS patients with PCI divided into 4 subgroups:
| Prasugrel + ASA versus clopidogrel + ASA for 1 year post-PCI | Patient-level simulation using statistical model from TRITON-TIMI trial (1 year) followed by Markov for 39 years | Clinical outcomes:
|
| Kazi DS43 | 2014 | US | PCI in ACS patients | Clopidogrel + ASA versus prasugrel + ASA versus ticagrelor + ASA versus genotype-guided treatment with ticagrelor or prasugrel and non-carrier with clopidogrel | Markov | Markov states:
|
| Mahoney EM47 | 2010 | US | PCI in ACS | Prasugrel + ASA versus clopidogrel + ASA for 6 to 15 months (TRITON-TIMI 38 trial) | Decision tree (15 months) | Health care resources from the TRITON-TIMI 38 trial (US, Australia, Canada, Germany, Italy, Spain, UK, France) Clinical events; bleeding, death, ischemia, MI, revascularization, stroke |
| Mauskopf JA48 | 2012 | US | PCI in ACS | Prasugrel + ASA versus clopidogrel + ASA for 15 months | Lifetime “disease-progression” model (separate rates for 1st month and months 2 to 15) | Model outcomes:
costs — medication, ER visits, in-patient stays clinical — CV events (MI, stroke, angina, death), bleeding events; revascularization, rehospitalizations, LYG
|
| Nikolic49 | 2013 | Sweden | ACS | Ticagrelor + ASA versus clopidogrel + ASA for 12 months | Decision tree for 1-year data from PLATO clinical study + Markov | Decision tree events:
death MI (non-fatal) stroke (non-fatal)
Markov states:
|
| Patel V50 | 2014 | US | PCI in ACS | Prasugrel + ASA versus clopidogrel + ASA versus genotype-guided treatment | Decision tree (15 months) | Event subtree:
bleeding (major) death MI revascularization stroke
Separate probabilities for month 1 and months 2 to15 |
| Wein B52 | 2017 | Denmark, Germany, Switzerland | ACS undergoing PCI | ASA 100 mg lifelong + clopidogrel 75 mg for 12 months versus ASA 100 mg lifelong + prasugrel 5 mg or 10 mg per day for 12 months | Decision tree (12 months) | Using BASKET-PROVE cohort Clinical events: MACCE, death, MI, revascularization, bleeding |
| Other Regimens |
|---|
| Heeg B41 | 2007 | UK | Secondary prevention in patients at high risk of CV events or stroke, or ACS | Antiplatelets in secondary prevention; multiple comparisons: clopidogrel versus ASA; clopidrogrel 1 year versus clopidogrel 28 days; dipyridamole + ASA versus ASA; Dipyridamole + ASA versus clopidogrel; ASA versus placebo | Markov (lifetime in a 60-year-old individual) | Health states:
death MI (first) MI (second) stroke (first) stroke (second) CV event (third)
Transition probabilities depend on time since start of treatment (0 months to 6 months; 6 months to 12 months; after 12 months) |
