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pubmed-article:11241016pubmed:abstractTextAn alternative clinical management strategy and cost analysis model is presented for patients with atrial fibrillation of >2 days' duration who may benefit from immediate cardioversion with self-administered low-molecular-weight heparin (enoxaparin) as a bridge antithrombotic therapy to warfarin, after a negative transesophageal echo-cardiography (TEE) screening for thrombus. Assuming no difference in stroke or bleeding rates, our cost minimization model shows that the TEE-guided enoxaparin treatment costs are $1353 lower per patient than an intravenous unfractionated heparin approach. Sensitivity analyses for stroke and bleeding reveal that the treatment-cost economic dominance of the TEE-guided enoxaparin approach may be enhanced by an expected improvement in clinical outcome.lld:pubmed
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pubmed-article:11241016pubmed:dateRevised2004-11-17lld:pubmed
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pubmed-article:11241016pubmed:articleTitlePotential clinical efficacy and cost benefit of a transesophageal echocardiography-guided low-molecular-weight heparin (enoxaparin) approach to antithrombotic therapy in patients undergoing immediate cardioversion from atrial fibrillation.lld:pubmed
pubmed-article:11241016pubmed:affiliationDepartment of Cardiology, Cardiovascular Imaging Center; the Department of Vascular Medicine, Clinical Thrombosis Section; and Biostatistics and Epidemiology; The Cleveland Clinic Foundation.lld:pubmed
pubmed-article:11241016pubmed:publicationTypeJournal Articlelld:pubmed