| Cost-effectiveness analysis of 64-slice computed tomography vs. cardiac catheterization to rule out coronary artery disease before non-coronary cardiovascular surgery. | |
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MedLine Citation:
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PMID: 22761509 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIMS: To explore the cost-effectiveness of two alternative strategies to rule out significant coronary artery disease (CAD) in the pre-operative evaluation of non-coronary cardiovascular surgery: initial pre-operative coronary 64-slice computed tomography angiography (CCTA) vs. invasive coronary angiography (ICA). METHODS AND RESULTS: These diagnostic strategies are compared from the clinical and payee's perspective, on the basis of the results of four European studies including 490 patients, by an analytic model of a decision tree in terms of the cost-effectiveness as the percentage of catheterizations, complications, and deaths avoided. These studies show that 71.2% of the ICA and 3.56% of the post-ICA complications could have been avoided by an initial pre-operative CCTA with a saving of €411/patient. The sensitivity analysis did not find relevant differences in terms of the cost-effectiveness when we established the indication of ICA vs. CCTA in relation to the amount of coronary calcium and when ICA was always performed by radial access. However, the lack of team experience in CCTA increased the economical and biological cost due to involving an ICA and the exposure to double ionizing radiation sources. CONCLUSION: In experienced groups, the diagnostic strategy with initial pre-operative CCTA is better than the strategy with initial ICA because it is capable of ruling out significant CAD avoiding ICA and post-ICA morbidity-mortality, with an important saving in the cost of the diagnostic process. |
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Authors:
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Paz Catalán; Daniel Callejo; Juan Antonio Blasco |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-7-2 |
Journal Detail:
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Title: European heart journal cardiovascular Imaging Volume: - ISSN: 2047-2412 ISO Abbreviation: Eur Heart J Cardiovasc Imaging Publication Date: 2012 Jul |
Date Detail:
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Created Date: 2012-7-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101573788 Medline TA: Eur Heart J Cardiovasc Imaging Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Cardiology Department, Ramón y Cajal University Hospital (Madrid), Ctra. Colmenar Km 9,100, 28034 Madrid, Spain. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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