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Cost Effectiveness Analysis In Patients With Heart Valve Prosthesis (HVP)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified December 2013 by Gihan Hamdy Elsisi, Pharmacoeconomic Unit, Egypt.
Recruitment status was:  Recruiting
Information provided by (Responsible Party):
Gihan Hamdy Elsisi, Pharmacoeconomic Unit, Egypt Identifier:
First received: December 20, 2013
Last updated: December 26, 2013
Last verified: December 2013
The combined Antiplatelet and Anticoagulant treatment decreased thrombus formation and overall mortality. Also the initiation of an efficacious early anticoagulation protocol is important because of its potential impact on the rate of early thromboembolic complications after mechanical valve implantation. An important question that remains to be answered is whether the combination would be cost effective than Warfarin alone, with a reduction in major bleeding. In addition, the knowledge about its cost-effectiveness has not yet been established in Egypt. The aim of this trial based economic evaluation is to conduct a cost-effectiveness analysis for combination of low-dose Aspirin and Warfarin versus Warfarin alone in prosthetic valve patients from the medical provider perspective specially that a misconception is still existed between the physicians in Egypt that the cost of complications is not worthy so our main aim is to test the cost of complications.

Condition Intervention Phase
Complications Due to Heart Valve Prosthesis Drug: Acetyl Salicylic Acid Drug: Warfarin Drug: Placebo (for Aspirin) Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Care Provider)
Primary Purpose: Prevention
Official Title: Cost Effectiveness Analysis for Combination Of Aspirin And Warfarin Versus Warfarin Alone In Egyptian Patients With Heart Valve Prosthesis

Resource links provided by NLM:

Further study details as provided by Gihan Hamdy Elsisi, Pharmacoeconomic Unit, Egypt:

Primary Outcome Measures:
  • Valve Thrombosis [ Time Frame: one year ]

Secondary Outcome Measures:
  • Major Systemic Embolism, [ Time Frame: one year ]
  • Non-fatal intracranial hemorrhage [ Time Frame: one year ]
  • Major extra cranial hemorrhage, [ Time Frame: one year ]

Estimated Enrollment: 300
Study Start Date: June 2013
Estimated Primary Completion Date: July 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Combination
Warfarin tablets adjusted according to international normalized ratio (INR) (2 for Aortic Valve Replacement & 2.5-3 for Mitral Valve Replacement, 2.5-3.5 for Double Valve Replacement) and oral 75 mg Acetyl Salicylic Acid tablets daily long life.
Drug: Acetyl Salicylic Acid
Other Name: Aspirin
Drug: Warfarin
Other Name: Marevan
Active Comparator: Warfarin
Warfarin tablets adjusted according to INR (2 for Aortic Valve Replacement & 2.5-3 for Mitral Valve Replacement, 2.5-3.5 for Double Valve Replacement) and placebo long life.
Drug: Warfarin
Other Name: Marevan
Drug: Placebo (for Aspirin)
Sugar pill manufactured to mimic 75 mg Aspirin

Detailed Description:

The measurements will be assessed:

A- Number of patients improved during follow up:

  1. Demographic data
  2. Diagnosis
  3. Laboratory tests (CBC, Prothrombin Time, liver and renal function tests)
  4. Echocardiography profile


Direct medical costs will be assessed directly from hospital's records and tender lists.


Ages Eligible for Study:   15 Years to 50 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Patients operated in Ain Shams University Hospitals for aortic and/ or mitral valve replacement.

Exclusion Criteria:

  • Congenital blood disorders, Hemophilia.
  • Advanced liver disease
  • Advanced renal disease (dialysis patients)
  • Aspirin sensitivity
  • Autoimmune diseases
  • Biological bioprosthesis valves
  • Non-compliant & Drop out patient
  • Pregnant women
  • Caucasians.
  Contacts and Locations
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Please refer to this study by its identifier: NCT02022527

Contact: Gihan H Elsisi, Msc +201227366018
Contact: Manal H Elhamamsy, PhD +201005257416

Ain Shams University hospitals Recruiting
Cairo, Egypt
Contact: Ahmed Hassouna, MD    +201223105271      
Sub-Investigator: Basma Awad, MD         
Sponsors and Collaborators
Pharmacoeconomic Unit, Egypt
Principal Investigator: Gihan H Elsisi, Msc Pharmacoeconomic Unit
Study Chair: Manal H Elhamamsy, PhD Faculty of pharmacy, Ain Shams University
Study Director: Mohamed ME Mazar, PhD Central Administration for Pharmaceutical Affairs
  More Information

Additional Information:
Responsible Party: Gihan Hamdy Elsisi, Head of Pharmacoeconomic Unit, Pharmacoeconomic Unit, Egypt Identifier: NCT02022527     History of Changes
Other Study ID Numbers: PEU2013
Study First Received: December 20, 2013
Last Updated: December 26, 2013

Keywords provided by Gihan Hamdy Elsisi, Pharmacoeconomic Unit, Egypt:
Heart valve prosthesis

Additional relevant MeSH terms:
Salicylic Acid
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Antirheumatic Agents
Fibrinolytic Agents
Fibrin Modulating Agents
Molecular Mechanisms of Pharmacological Action
Platelet Aggregation Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Anti-Infective Agents
Antifungal Agents
Keratolytic Agents
Dermatologic Agents processed this record on September 21, 2017