[Aspects of drug safety in the German code of social security]

Health economic aspects of breast cancer treatment: the compulsory health insurances' view

Due to the impact of rising expenditures for the delivery of high-standard health care, further efforts supporting evidence-based, cost-efficient and patient-centered management in oncology are advised. This also concerns the treatment of patients with breast cancer. Reimbursement of diagnostic and/or therapeutic innovations in oncologic health care within the compulsory health insurances (CHIs) in Germany requests their evidence-based proof of benefit and medical need. Using selected examples in pharmacotherapy, recommendations to improve outpatient breast cancer care are discussed.

Cardiac troponin T and advanced glycation end-products in hemodialysis patients

BACKGROUND

Cardiac troponin T (cTnT) is used as a biomarker of myocardial damage for the diagnosis of acute myocardial infarction and acute coronary syndrome. The aim was to investigate the association between advanced glycation end products (AGEs) and cTnT in hemodialysis (HD) patients.

METHODS

The plasma level of cTnT in 224 HD patients was measured using the electrochemiluminescence immunoassay. The plasma levels of N(epsilon)-(carboxymethyl)lysine (CML) and pentosidine were measured using an enzyme-linked immunosorbent assay.

RESULTS

The cTnT-positive group (>0.1 ng/ml) showed significantly high plasma levels of calcium, CML and pentosidine as compared with the cTnT-negative group. In multiple logistic regression analysis, the prevalence of patients with high plasma calcium (>median) was increased in the cTnT-positive group as compared with the cTnT-negative group (OR: 5.08, 95% CI: 1.62-15.92, p < 0.01). The prevalence of high plasma CML (>median) was increased in the cTnT-positive group (OR: 4.45, 95% CI: 1.41-14.03, p < 0.05). Further, the prevalence of high plasma pentosidine (>median) was also increased in the cTnT-positive group (OR: 4.94, 95% CI: 1.55-15.70, p < 0.01).

CONCLUSION

In addition to calcium, AGEs such as CML and pentosidine were associated with cTnT, a marker of myocardial damage, in HD patients.