Cost-effectiveness analysis of 64-slice computed tomography vs. cardiac catheterization to rule out coronary artery disease before non-coronary cardiovascular surgery

Catalán, Paz; Callejo, Daniel; Blasco, Juan Antonio

doi:10.1093/ehjci/jes121

Cited by 10 publications

(4 citation statements)

References 32 publications

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“… 4 In addition, in 2012, an European study emphasized the importance of having a preoperative strategy, not only because it is a more comfortable diagnostic alternative for the patient, but also more inexpensive than the conventional strategy. 24 …”

Section: Discussionmentioning

confidence: 99%

Prevalence and Prediction of Obstructive Coronary Artery Disease in Patients Undergoing Primary Heart Valve Surgery

Cazelli¹,

Camargo²,

Kruczan³

et al. 2017

Arquivos Brasileiros De Cardiologia

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BackgroundThe prevalence of coronary artery disease (CAD) in valvular patients is similar to that of the general population, with the usual association with traditional risk factors. Nevertheless, the search for obstructive CAD is more aggressive in the preoperative period of patients with valvular heart disease, resulting in the indication of invasive coronary angiography (ICA) to almost all adult patients, because it is believed that coronary artery bypass surgery should be associated with valve replacement.ObjectivesTo evaluate the prevalence of obstructive CAD and factors associated with it in adult candidates for primary heart valve surgery between 2001 and 2014 at the National Institute of Cardiology (INC) and, thus, derive and validate a predictive obstructive CAD score.MethodsCross-sectional study evaluating 2898 patients with indication for heart surgery of any etiology. Of those, 712 patients, who had valvular heart disease and underwent ICA in the 12 months prior to surgery, were included. The P value < 0.05 was adopted as statistical significance.ResultsThe prevalence of obstructive CAD was 20%. A predictive model of obstructive CAD was created from multivariate logistic regression, using the variables age, chest pain, family history of CAD, systemic arterial hypertension, diabetes mellitus, dyslipidemia, smoking, and male gender. The model showed excellent correlation and calibration (R² = 0.98), as well as excellent accuracy (ROC of 0.848; 95%CI: 0.817-0.879) and validation (ROC of 0.877; 95%CI: 0.830 - 0.923) in different valve populations.ConclusionsObstructive CAD can be estimated from clinical data of adult candidates for valve repair surgery, using a simple, accurate and validated score, easy to apply in clinical practice, which may contribute to changes in the preoperative strategy of acquired heart valve surgery in patients with a lower probability of obstructive disease.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Prediction of Obstructive Coronary Artery Disease in Patients Undergoing Primary Heart Valve Surgery

Cazelli¹,

Camargo²,

Kruczan³

et al. 2017

Arquivos Brasileiros De Cardiologia

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“…26 Probability pathway models, decision tree models, and simulations are used on a variety of health care topics to determine the fi nancial impact of an intervention when observational data are unavailable or impractical to collect. These include comparisons of competing drugs for a specifi c condition, 27-30 comparison of new imaging technologies with improved diagnostic accuracy, [31][32][33] and evaluation of a novel procedure, practice guideline, practice model, or treatment. [34][35][36][37] The results of this study are needed to determine the value of an investment in robotic sterile medication dose preparation technology versus alternative uses of fi nancial resources in the health care system.…”

Section: Discussionmentioning

confidence: 99%

“…Probability pathway models, decision tree models, and simulations are used on a variety of health care topics to determine the financial impact of an intervention when observational data are unavailable or impractical to collect. These include comparisons of competing drugs for a specific condition, 27–30 comparison of new imaging technologies with improved diagnostic accuracy, 31–33 and evaluation of a novel procedure, practice guideline, practice model, or treatment. 34–37…”

Section: Discussionmentioning

confidence: 99%

Estimated Cost Savings from Reducing Errors in the Preparation of Sterile Doses of Medications

Urbine

Schneider

2014

Hosp Pharm

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“…Coronary computed tomography (CT) angiography (CTCA) may be considered as an alternative to invasive coronary angiography to rule out significant coronary artery disease (CAD) before non-coronary cardiac surgery. An analysis of Catalan et al 20 was based on the results of four European studies and indicated that in experienced hands, the use of initial pre-operative CTCA could have avoided many invasive coronary angiographies and resulted in a more cost-effective strategy than the conventional invasive coronary angiography strategy.…”

Section: Vhd and Cardiac Computed Tomographymentioning

confidence: 99%

The year 2018 in the European Heart Journal—Cardiovascular Imaging: Part II

Cosyns

Haugaa

Gerber

et al. 2019

European Heart Journal - Cardiovascular Imaging

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European Heart Journal - Cardiovascular Imaging was launched in 2012 as a multimodality cardiovascular imaging journal. It has gained an impressive impact factor during its first 5 years and is now established as one of the top cardiovascular journals and has become the most important cardiovascular imaging journal in Europe. The most important studies from 2018 will be highlighted in two reports. Part I of the review has focused on studies about myocardial function and risk prediction, myocardial ischaemia, and emerging techniques in cardiovascular imaging, while Part II will focus on cardiomyopathies, congenital heart diseases, valvular heart diseases, and heart failure.

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Cost-effectiveness analysis of 64-slice computed tomography vs. cardiac catheterization to rule out coronary artery disease before non-coronary cardiovascular surgery

Cited by 10 publications

References 32 publications

Prevalence and Prediction of Obstructive Coronary Artery Disease in Patients Undergoing Primary Heart Valve Surgery

Prevalence and Prediction of Obstructive Coronary Artery Disease in Patients Undergoing Primary Heart Valve Surgery

Estimated Cost Savings from Reducing Errors in the Preparation of Sterile Doses of Medications

The year 2018 in the European Heart Journal—Cardiovascular Imaging: Part II

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