稳定型胸痛综合征和疑似冠状动脉疾病患者诊断评估策略的成本效益
Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease.
作者信息
Min James K, Gilmore Amanda, Jones Erica C, Berman Daniel S, Stuijfzand Wijnand J, Shaw Leslee J, O'Day Ken, Danad Ibrahim
机构信息
The Department of Medicine and Radiology, Weill Medical College of Cornell University, Dalio Institute of Cardiovascular Imaging, The New York Presbyterian Hospital, New York, NY, United States.
Xcenda Corporation, Palm Harbor, FL, United States.
出版信息
Clin Imaging. 2017 May-Jun;43:97-105. doi: 10.1016/j.clinimag.2017.01.015. Epub 2017 Feb 10.
Abstract
PURPOSE
To determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD).
METHODS
Exercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other.
RESULTS
Initial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging.
CONCLUSION
As pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.
摘要
目的
确定针对稳定型胸痛且疑似冠心病（CAD）患者的诊断评估策略的终身成本效益。
方法
单独评估或相互连续评估运动平板试验（ETT）、负荷超声心动图（SE）、心肌灌注显像（MPS）、冠状动脉计算机断层血管造影（CCTA）和有创冠状动脉造影（ICA）。
结果
初始进行ETT，随后在ETT结果不明确或无法进行时进行成像检查，似乎比任何采用初始成像检查的策略更具成本效益。
结论
由于CAD的预测试验可能性各不相同，包括SE、CCTA和MPS在内的不同检查方法可降低成本并提高有效性。
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