Stress echocardiography-based strategies are cheaper, less risky

According to an analysis published online May 29 in Cardiovascular Ultrasoundan stress echocardiography-based strategies are cost effective and negate the risk of radiation exposure compared to alternative imaging strategies.

The researchers noted that the diagnosis costs for cardiovascular disease waste a large amount of healthcare resources. and aimed to evaluated direct and indirect downstream costs of six strategies:

  1. Coronary angiography (CA) after positive troponin I or T (cTn-I or cTnT)
  2. After positive exercise electrocardiography (ex-ECG)
  3. After positive exercise echocardiography (ex-Echo)
  4. After positive pharmacologic stress echocardiography (PhSE)
  5. After positive myocardial exercise stress SPECT with technetium Tc 99m sestamibi (ex-SPECT-Tc)
  6. Direct CA.

Accordingly to the article, investigators found that;

  • The predictive accuracy in correctly identifying the patients was 83.1 percent for cTn-I; 87 percent for cTn-T; 85.1 percent for ex-ECG; 93.4 percent for ex-Echo; 98.5 percent for PhSE; 89.4 percnet for ex-SPECT-Tc; and 18.7 percent for CA.
  • The average relative cost-effectiveness of cardiac imaging compared with the PhSE equal to one (as a cost comparator), the relative cost of ex-Echo is 1.5x; of a ex-SPECT-Tc is 3.1x; of a ex-ECG is 3.5x; of cTnI is x3.8; of cTnT is x3.9; and of a CA is 56.3x.
  • C=cost per patient correctly identified results $2.051 for cTn-I; $2.086 for cTn-T; $1.890 for ex-ECG; $803 for ex-Echo; $533 for PhSE; $1.521 for ex-SPECT-Tc ($1.634 including cost of extra risk of cancer); and $29.673 for CA ($29.999 including cost of extra risk of cancer).

Plan well for everything and the benefits will be extended to all 🙂

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