Computed Tomographic Coronary Angiography for Diagnosing Stable Coronary Artery Disease - A Cost-Utility and Cost-Effectiveness Analysis
Computed Tomographic Coronary Angiography for Diagnosing Stable Coronary Artery Disease - A Cost-Utility and Cost-Effectiveness Analysis
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DOI：
10.1253/circj.cj-08-1186
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发表时间：
2009-07-01
影响因子：
3.3
通讯作者：
Takao, Hidemasa
中科院分区：
文献类型：
--
作者：
Amemiya, Shiori;Takao, Hidemasa
背景资料：评价使用64排多探测器计算机断层扫描冠状动脉造影（CTCA）作为冠心病（CAD）风险患者的无创成像方式的终身潜在获益和成本效益。方法和结果：使用马尔可夫模型进行决策和成本效益分析，比较4种策略：（1）无检查，（2）常规冠状动脉造影（CAG），（3）CTCA，或（4）在有稳定性CAD风险的人群中，无CAG或CTCA的药物治疗。与无检查和无治疗策略相比，CTCA获得了0.551质量调整生命年（QALY），每QALY的增量成本效果比（ICER）为15，581美元（2007年）。与CTCA策略相比，常规CAG的QALY增加了0.012，ICER为每个QALY 445，276美元。结论：使用CTCA作为有稳定性CAD风险的60岁男性的一线检查，QALY的增加与常规CAG相当，但成本更低。(Circ J 2009; 73：1263-1270）
Background: To evaluate the lifetime potential benefits and cost-effectiveness of using 64 multidetector-row computed tomography coronary angiography (CTCA) as a noninvasive imaging modality for patients at risk for coronary artery disease (CAD).Methods and Results: A decision and cost-effective analysis using a Markov model was performed to compare 4 strategies: (1) no examination, (2) routine coronary angiography (CAG), (3) CTCA, or (4) medication without CAG or CTCA in persons at risk for stable CAD. Compared with the no examination and no treatment strategies, CTCA gained 0.551 quality-adjusted life-years (QALYs) with an incremental cost-effectiveness ratio (ICER) of US$15,581 (in 2007) per QALY. Routine CAG gained 0.012 QALYs compared with the CTCA strategy, with an ICER of US$445,276 per QALY.Conclusions: Using CTCA as the first-line examination for 60-year-old men at risk for stable CAD achieved gains of QALY comparable to that of routine CAG, but at a lower cost. (Circ J 2009; 73: 1263-1270)