A cost-effectiveness evaluation of a high-sensitivity troponin I guided voluntary cardiovascular risk assessment program for asymptomatic women in Croatia.

Autor:	Krstačić G; Institute for Cardiovascular Prevention and Rehabilitation (Srčana), Zagreb, Croatia.; J. J. Strossmayer University of Osijek Faculty of Dental Medicine and Health, Osijek, Croatia.; J. J. Strossmayer University of Osijek Faculty of Medicine, Osijek, Croatia., Jülicher P; Medical Affairs, Core Diagnostics, Abbott, Abbott Park, IL, USA., Krstačić A; J. J. Strossmayer University of Osijek Faculty of Dental Medicine and Health, Osijek, Croatia.; J. J. Strossmayer University of Osijek Faculty of Medicine, Osijek, Croatia.; University Hospital Center Sisters of Mercy, Zagreb, Croatia., Varounis C; Medical Affairs, Core Diagnostics, Abbott, Abbott Park, IL, USA.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Cardiovascular risk and prevention [Int J Cardiol Cardiovasc Risk Prev] 2024 Feb 10; Vol. 20, pp. 200244. Date of Electronic Publication: 2024 Feb 10 (Print Publication: 2024).
DOI:	10.1016/j.ijcrp.2024.200244
Abstrakt:	Background: To estimate the effectiveness and cost-effectiveness of a high-sensitivity troponin I (hsTnI) guided cardiovascular risk assessment program in women in Croatia. Methods: An observational study of a voluntary program for cardiovascular disease (CVD) risk assessment in women aged above 45 years with no specific symptoms, no confirmed or known coronary artery disease was conducted (WHP). Participants were stratified into three categories according to their hsTnI level. Subjects in the moderate or high-risk class were referred to cardiac work-up and invasive cardiovascular investigation as appropriate. Study information were applied to a discrete-event simulation model to estimate the cost-effectiveness of WHP against current practice. The number of CVD events and deaths, costs, and quality-adjusted life years (QALY) were assessed over 10 years from a societal perspective. Results: Of 1034 women who participated in the program, 921 (89.1%), 100 (9.7%), and 13 (1.3%) subjects fall into the low, moderate, and high-risk class. Of 26 women referred for angiography, significant coronary artery disease (CAD) was diagnosed in 12 women (46.1%). WHP gained 15.8 (95%CI 12.8; 17.2) QALYs per 1000 subjects, increased costs by 490€ (95%CI 487; 500), decreased CVD-related mortality by 40%. At a willingness-to-pay threshold of 45,000 €/QALY, WHP was cost-effective with a probability of 90%. Model results were most sensitive to utility weights and cost of medical prevention. Conclusions: Assessing the cardiovascular risk in asymptomatic women with hsTnI and guiding those at higher risk to further cardiac testing, identified individuals with CAD, could reduce CVD related burden, and would be cost-effective. Competing Interests: PJ and CV are full-time employees of Abbott. GK and AK report no relationships that could be construed as a conflict of interest. (© 2024 The Authors.)
Databáze:	MEDLINE
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