Cost-effectiveness of myocardial perfusion SPECT and stress test according to coronary revascularization therapy, cardiac events and total mortality: Register of 8,496 patients. / Coste-efectividad de la SPECT de perfusión miocárdica y de la prueba de esfuerzo en relación con la revascularización coronaria, eventos cardíacos y mortalidad total. Registro de 8.496 pacientes.
Rev Esp Med Nucl Imagen Mol (Engl Ed)
; 39(4): 212-219, 2020.
Article
en En, Es
| MEDLINE
| ID: mdl-32273238
OBJECTIVE: The aim was to analyze the cost-effectiveness ratio (CER) of stress electrocardiogram (ES) and stress myocardial perfusion imaging (SPECT-MPI) according to coronary revascularization (CR) therapy, cardiac events (CE) and total mortality (TM). MATERIAL AND METHODS: A total of 8,496 consecutive patients who underwent SPECT-MPI were followed-up (mean 5.3±3.5years). Cost-effectiveness for coronary bypass (CABG) or percutaneous CR (PCR) (45.6%/54.4%) according to combined electrocardiographic ischemia and scintigraphic ischemia were evaluated. Effectiveness was evaluated as TM, CE, life-year saved observed (LYSO) and CE-LYSO; costs analyses were conducted from the perspective of the health care payer. A sensitivity analysis was performed considering current CABG/PCR ratios (12%/88%). RESULTS: When electrocardiogram and SPECT approaches are combined, the cost-effectiveness values for CABG ranged between 112,589 (electrocardiographic and scintigraphic ischemia) and 2,814,715 (without ischemia)/event avoided, 38,664 and 2,221,559/LYSO; for PCR ranged between 18,824 (electrocardiographic and scintigraphic ischemia) and 46,377 (without ischemia)/event avoided, 6,464 and 36,604/LYSO. To CE: the cost-effectiveness values of the CABG and CPR in presence of electrocardiographic and scintigraphic ischemia were 269,904/CE-avoided and 24,428/CE-avoided, respectively; and the /LYSO of the CABG and PCR were 152,488 and 13,801, respectively. The RCE was maintained for the current proportion of revascularized patients (12%/88%). CONCLUSIONS: Combined ES and SPECT-MPI results, allows differentiation between patient groups, where the PCR and CABG are more cost-effective in different economic frameworks. The major CER in relation to CR, CE and TM occurs in patients with electrocardiographic and scintigraphic ischemia. PCR is more cost-effective than CABG.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tomografía Computarizada de Emisión de Fotón Único
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Isquemia Miocárdica
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Prueba de Esfuerzo
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Imagen de Perfusión Miocárdica
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Revascularización Miocárdica
Tipo de estudio:
Diagnostic_studies
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Health_economic_evaluation
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
/
Es
Revista:
Rev Esp Med Nucl Imagen Mol (Engl Ed)
Año:
2020
Tipo del documento:
Article
Pais de publicación:
España