Cost-effectiveness of cardiovascular magnetic resonance imaging compared to common strategies in the diagnosis of coronary artery disease: a systematic review.

Autor: Azari S; Hospital Management Research Center, Health Management Research Institute, University of Medical Sciences, Tehran, Iran.; Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran., Pourasghari H; Hospital Management Research Center, Health Management Research Institute, University of Medical Sciences, Tehran, Iran., Fazeli A; Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran., Ghorashi SM; Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran., Arabloo J; Health Management and Economics Research Center, Health Management Research Institute, University of Medical Sciences, Tehran, Iran., Rezapour A; Health Management and Economics Research Center, Health Management Research Institute, University of Medical Sciences, Tehran, Iran., Behzadifar M; Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran., Khorgami MR; Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran., Salehbeigi S; Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran., Omidi N; Cardiovascular Disease Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. negar.omidi@gmail.com.
Jazyk: angličtina
Zdroj: Heart failure reviews [Heart Fail Rev] 2023 Nov; Vol. 28 (6), pp. 1357-1382. Date of Electronic Publication: 2023 Aug 03.
DOI: 10.1007/s10741-023-10334-1
Abstrakt: Cardiovascular magnetic resonance imaging (CMR) has established exceptional diagnostic utility and prognostic value in coronary artery disease (CAD). An assessment of the current evidence on the cost-effectiveness of CMR in patients referred for the investigation of CAD is essential for developing an economic model to evaluate the cost-effectiveness of CMR in CAD. We conducted a comprehensive search of multiple electronic databases, including PubMed, Scopus, Web of Science core collection, Embase, National Health Service Economic Evaluation Database (NHS EED), and health technology assessment, to identify relevant literature. After removing duplicates and screening the title/abstract, a total of 13 articles were deemed eligible for full-text assessment. We included studies that reported one or more of the following outcomes: incremental cost-effectiveness ratio (ICER), cost per quality-adjusted life year (QALYs), cost per life year gained, sensitivity and specificity rate as the primary outcome, and health utility measures or health-related quality of life as the secondary outcome. The quality of the included studies was assessed using the CHEERS 2022 guidelines. The findings of this study demonstrate that in patients undergoing urgent percutaneous coronary intervention, CMR over a one-year and lifetime horizon leads to higher quality-adjusted life years (QALYs) compared to current strategies in cases of multivessel disease. The systematic review indicates that the CMR-based strategy is more cost-effective when compared to standard methods such as single-photon emission computed tomography (SPECT), coronary computed tomography angiography (CCTA), and coronary angiography (CA) (CMR = $19,273, SPECT = $19,578, CCTA = $19,886, and immediate CA = $20,929). The results also suggest that the CMR strategy can serve as a cost-effective gatekeeping tool for patients at risk of obstructive CAD. A CMR-based strategy for managing patients with suspected CAD is more cost-effective compared to both invasive and non-invasive strategies, particularly in real-world patient populations with a low to intermediate prevalence of the disease.
(© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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