高危急性冠状动脉综合征患者连续实时心内复发事件检测与警报的成本效益
Cost-effectiveness of continuous real-time intracardiac recurrent event detection and alerting in high-risk acute coronary syndrome patients.
作者信息
Sanders Schmidler Gillian D, John M Sasha, Voigt Jeffrey D, Krucoff Mitchell W
机构信息
Duke Clinical Research Institute, Duke University, Durham, NC, USA.
Duke-Margolis Institute for Health Policy, Duke University, Durham, NC, USA.
出版信息
Future Cardiol. 2025 Feb;21(2):83-93. doi: 10.1080/14796678.2025.2457831. Epub 2025 Jan 31.
BACKGROUND
ALERTS was a pivotal randomized clinical trial (RCT) evaluating an intracardiac monitor with real-time alerting in high-risk acute coronary syndrome patients. The cost-effectiveness however is unknown.
METHOD
A decision model estimated health effects and costs of implanting a Guardian device in a target patient population, compared to current standard-of-care (SOC). Health and economic outcomes were modeled using ALERTS trial results and relevant literature.
RESULTS
Base-case analysis indicated an incremental lifetime cost of $21,988 with Guardian as compared to SOC (increase of 0.18 life years or 0.37 quality-adjusted life years (QALY)). The incremental cost-effectiveness ratio (ICER) was $121,056/LY or $58,668/QALY.
CONCLUSION
Real-time intracardiac monitoring with patient alerting was cost-effective using conventional thresholds in acute coronary syndrome (ACS) patients at high-risk for recurrent events.
背景
ALERTS是一项关键的随机临床试验（RCT），评估了一种用于高危急性冠状动脉综合征患者的具有实时警报功能的心脏内监测器。然而，其成本效益尚不清楚。
方法
一个决策模型估计了在目标患者群体中植入Guardian设备相对于当前标准治疗（SOC）的健康影响和成本。使用ALERTS试验结果和相关文献对健康和经济结果进行建模。
结果
基础案例分析表明，与SOC相比，使用Guardian的终身增量成本为21,988美元（增加0.18生命年或0.37质量调整生命年（QALY））。增量成本效益比（ICER）为121,056美元/生命年或58,668美元/QALY。
结论
对于复发事件高危的急性冠状动脉综合征（ACS）患者，使用传统阈值进行患者警报的实时心脏内监测具有成本效益。
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