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:
- Coronary angiography (CA) after positive troponin I or T (cTn-I or cTnT)
- After positive exercise electrocardiography (ex-ECG)
- After positive exercise echocardiography (ex-Echo)
- After positive pharmacologic stress echocardiography (PhSE)
- After positive myocardial exercise stress SPECT with technetium Tc 99m sestamibi (ex-SPECT-Tc)
- 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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