Cost evaluation and comparison of three decision strategies for cardiac revascularization: results of the suspected CAD protocol of the European CMR registry

TitreCost evaluation and comparison of three decision strategies for cardiac revascularization: results of the suspected CAD protocol of the European CMR registry
Publication TypeJournal Article
Year of Publication2015
AuthorsMoschetti, K, Petersen, SE, Pilz, G, Kwong, RY, Lombardi, M, Korosoglou, G, Van Rossum, AC, Bruder, O, Mahrholdt, H, Schwitter, J
JournalEuropean Heart Journal
Volume36
Pagination1113
Type of ArticleMeeting Abstract
ISBN Number0195-668X
Accession Numberserval:BIB_9A3F363130EA
Abstract

Background: The public health burden of coronary artery disease (CAD) is important. Perfusion cardiac magnetic resonance (CMR) is generally accepted to detect and monitor CAD. Few studies have so far addressed its costs and costeffectiveness.

Objectives: To compare in a large CMR registry the costs of a CMR-guided strategy vs two hypothetical invasive strategies for the diagnosis and the treatment of patients with suspected CAD.

Methods: In 3'647 patients with suspected CAD included prospectively in the EuroCMR Registry (59 centers; 18 countries) costs were calculated for diagnostic examinations, revascularizations as well as for complication management over a 1-year follow-up. Patients with ischemia-positive CMR underwent an invasive X-ray coronary angiography (CXA) and revascularization at the discretion of the treating physician (=CMR+CXA strategy). Ischemia was found in 20.9% of patients and 17.4% of them were revascularized. In ischemia-negative patients by CMR, cardiac death and non-fatal myocardial infarctions occurred in 0.38%/y. In a hypothetical invasive arm the costs were calculated for an initial CXA followed by FFR testing in vessels with ≥50% diameter stenoses (=CXA+FFR strategy). To model this hypothetical arm, the same proportion of ischemic patients and outcome was assumed as for the CMR+CXA strategy. The coronary stenosis - FFR relationship reported in the literature was used to derive the proportion of patients with ≥50% diameter stenoses (Psten) in the study cohort. The costs of a CXA-only strategy were also calculated. Calculations were performed from a third payer perspective for the German, UK, Swiss, and US healthcare systems.

Notes

Congress of the European-Society-of-Cardiology (ESC), London, ENGLAND, AUG 29-SEP 02, 2015

WOS ID (UT)

000361205107339

Citation Key / SERVAL ID6444
Peer reviewRefereed

                         

IUMSP | www.iumsp.ch
Institut universitaire de médecine sociale et préventive
Route de la Corniche 10, 1010 Lausanne - Switzerland
+41 21 314 72 72 | iumsp@chuv.ch

Go to top