Effects of cardiovascular single pill combinations compared with identical multi-pill therapies on healthcare cost and utilization in Germany

Aim: This study assessed whether a single pill combination (SPC) is associated with lower direct healthcare costs. Materials & methods: Anonymized claims data of patients ≥18 years treated with drugs for cardiovascular (CV)-related diseases either as a single pill combination or multi-pill combination (followup to 1 year) were evaluated. After propensity score matching, 59,336 out of 1,369,840 patients were analyzed. Results: In all cohorts, patients receiving a single pill combination had a lower frequency of general practitioner and specialist visits. The patients also had a significantly lower ratio of all-cause hospitalization days and number of CV-related prescriptions as well as all-cause prescriptions (with one exception) compared with those receiving a multi-pill combination. Conclusion: Direct CV-related costs were significantly lower in four out of seven comparisons, with a trend toward lower costs in the other three comparisons

2023 ESC Guidelines for the management of acute coronary syndromes.

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Angiotensin II Type 1 Receptor Antagonism Improves

The online version of this article, along with updated information and services, is located on th

Prospective clinical evaluation of chairside-fabricated zirconia-reinforced lithium silicate ceramic partial crowns—5-year results

Objectives!#!A university-based randomized clinical study evaluated the 5-year performance of chairside-fabricated zirconia-reinforced lithium silicate (ZLS)-ceramic partial crowns.!##!Material and methods!#!Forty-five patients were restored with 61 chairside-fabricated ZLS-restorations (Cerec SW 4.2, Dentsply Sirona, Germany; Vita Suprinity, Vita Zahnfabrik, Germany). Deviating from the manufacturers' recommendations, restorations with reduced minimum material thicknesses (MMT) were fabricated: group 1, MMT = 0.5-0.74 mm (n = 31); group 2, MMT = 0.75-1.0 mm (n = 30). For luting, a self-adhesive cement (SAC) or a total-etch technique with a composite cement (TEC) was applied. Statistical evaluation was performed by time-to-event analysis (Kaplan-Meier). Possible covariates of the survival (SVR) and success rates (SCR), evaluated in a Cox regression model, were MMT, restoration position (premolar/molar), and cementation technique (SAC vs. TEC).!##!Results!#!Forty patients (54 restorations, premolars, n = 23; molars, n = 31) participated in the 5-year follow-up. Five losses due to ceramic fractures occurred in group 1 (n = 28) (SVR: 83.0% [95% confidence interval (CI): 0.71-0.96]). Group 2 (n = 26) showed no losses (SVR: 100%). The success rate for partial crowns placed on premolars was 100% and 69% (95% CI: 0.54-0.84) for molar restorations. Recementation was required in 4 restorations with SAC (SCR: 86% [95% CI: 0.73-0.99]; SCR-DC: 100%). Restorations in group 2 showed a significantly reduced risk of material fracture hazard ratio (HR) = 0.09, p = 0.0292) compared with the restorations in group 1. Molar partial crowns showed an increased risk for a clinical intervention (HR = 5.26, p = 0.0222) compared to premolar restorations.!##!Conclusions!#!Material thickness and position of the restoration are risk factors influencing the survival and success rate of ZLS-ceramic partial crowns.!##!Clinical relevance!#!Observation of an MMT of at least 0.75-1.0 mm for ZLS-ceramics is essential to avoid material-related fractures.!##!Clinical trial registration!#!German Clinical Trails Register (trial number: DRKS00005611)