Cost-Effectiveness Analysis of Stress Cardiovascular Magnetic Resonance Imaging for Stable Chest Pain Syndromes

Ge, Yin; Pandya, Ankur; Steel, Kevin; Bingham, Scott E.; Jerosch‐Herold, Michael; Chen, Yiyun; Mikolich, J. Ronald; Arai, Andrew E; Bandettini, W. Patricia; Patel, Amit R.; Farzaneh‐Far, Afshin; Heitner, John F.; Shenoy, Chetan; Leung, Steve W.; González, Jorge A.; Shah, Dipan J.; Raman, Subha V.; Ferrari, Victor A.; Schulz‐Menger, Jeanette; Hachamovitch, Rory; Stuber, Matthias; Simonetti, Orlando P.; Kwong, Raymond Y.

doi:10.1016/j.jcmg.2020.02.029

Cited by 72 publications

(56 citation statements)

References 35 publications

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“…Additional essential factors to increase the use of cardiac MRI are appropriate training and increased awareness of the utility of cardiac MRI for the diagnosis of myocardial inflammation. Another factor limiting the widespread use of cardiac MRI in clinical practice are the difficulties for the reimbursement of cardiac MRI associated costs in many regions worldwide, even though cost-effectiveness and value for the health-care system have been proven for various clinical indications [177][178][179] . In addition, the utility of cardiac MRI is often limited in patients with haemodynamic instability owing to fast or irregular heart rates and mechanical ventilation 2,162 .…”

Section: Imagingmentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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Inflammatory cardiomyopathy is defined as myocarditis in association with cardiac dysfunction and ventricular remodelling 1,2. Despite extensive research and improved diagnosis and understanding of the pathogenesis of inflammatory cardiomyopathy, this disorder is still associated with a poor prognosis when complicated by left ventricular (LV) dysfunction, heart failure (HF) or arrhythmia 3. Furthermore, fulminant myocarditis, a rare, sudden and severe cardiac inflammation, is one of the main causes of cardiogenic shock in young adults 4,5. Prompt diagnosis and specific treatment strategies are needed to reduce mortality and the need for heart transplantation in these patients 4,5. Many questions remain unanswered regarding the pathogenesis of inflammatory cardiomyopathy and the role of the viral infection, the immune system, the host genetic background and the environment in disease progression and prognosis. These gaps in knowledge highlight the need for advanced experimental systems that can better model the human immune system and the need to improve the characterization and classification of the patients, for example, with the use of phenomapping and phenomics, which involve detailed evaluation of immune status, viral presence and/or other biomarkers. In this Review, we discuss the available evidence and identify the gaps in our understanding of the pathogenesis, diagnosis, treatment and prognosis of myocarditis and inflammatory cardiomyopathy, appraise the available animal and cell models of these conditions and propose future directions for the field. We discuss the role

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Section: Imagingmentioning

confidence: 99%

Myocarditis and inflammatory cardiomyopathy: current evidence and future directions

et al. 2020

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“…Troškovna učinkovitost istraživanja SPINS pokazala je da stresni CMR može biti troškovno učinkovita metoda za izbjegavanje invazivne koronarografije (ICA) u bolesnika s rizikom od opstruktivne CAD. 16 Posebice porast stope troškovne učinkovitosti za strategiju koja u osnovi ima CMR u usporedbi s neslikovnom strategijom iznosi 52 000 USD/kvalitetno provedenih godina života (QALY), dok je porast troškovne učinkovitosti za neposrednu ICA bio 12 milijuna USD/QALY, kada je usporedimo s CMR-om.…”

Section: Ehokardiografijaunclassified

“…The cost-effectiveness study of SPINS demonstrated that, stress CMR can be a cost-effective gatekeeping tool prior to invasive coronary angiography (ICA) in patients at risk for obstructive CAD. 16 In particular, the incremental cost-effectiveness ratio for the CMR-based strategy compared with the no-imaging strategy was $52 000/ quality-adjusted life years (QALY), whereas the incremental cost-effectiveness ratio for the immediate ICA strategy was $12 million/QALY compared with CMR.…”

Section: Ehokardiografijamentioning

confidence: 99%

The year in cardiovascular medicine 2020: imaging

Zamorano¹,

Pinto²,

Solano-López³

et al. 2021

Cardiologia Croatica

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“…In the ISCHEMIA trial, CCTA was primarily aimed at ruling out the presence of significant unprotected left main disease -but surprisingly not a proximal three-vessel disease -and to confirm the presence of obstructive CAD in patients with at least moderate ischemia. Claiming that CCTA should be performed at a population level where the prevalence of the left main disease is predictably low has the potential of exposing a significant number of patients to ionizing radiation and nephrotoxic contrast agents, when alternative and more costeffective options are available [10,11].…”

Section: Umberto Ianni MD and Marco Zimarino Md Phdmentioning

confidence: 99%