Cost-effectiveness of coronary artery calcium testing for coronary heart and cardiovascular disease risk prediction to guide statin allocation: the Multi-Ethnic Study of Atherosclerosis (MESA)

PloS One
Eric T RobertsKhurram Nasir

Abstract

The Multi-Ethnic Study of Atherosclerosis (MESA) showed that the addition of coronary artery calcium (CAC) to traditional risk factors improves risk classification, particularly in intermediate risk asymptomatic patients with LDL cholesterol levels <160 mg/dL. However, the cost-effectiveness of incorporating CAC into treatment decision rules has yet to be clearly delineated. To model the cost-effectiveness of CAC for cardiovascular risk stratification in asymptomatic, intermediate risk patients not taking a statin. Treatment based on CAC was compared to (1) treatment of all intermediate-risk patients, and (2) treatment on the basis of United States guidelines. We developed a Markov model of first coronary heart disease (CHD) and cardiovascular disease (CVD) events. We modeled statin treatment in intermediate risk patients with CAC≥1 and CAC≥100, with different intensities of statins based on the CAC score. We compared these CAC-based treatment strategies to a "treat all" strategy and to treatment according to the Adult Treatment Panel III (ATP III) guidelines. Clinical and economic outcomes were modeled over both five- and ten-year time horizons. Outcomes consisted of CHD and CVD events and Quality-Adjusted Life Years (QALYs). ...Continue Reading

References

May 23, 2001·JAMA : the Journal of the American Medical Association·UNKNOWN Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
Jan 15, 2004·JAMA : the Journal of the American Medical Association·Philip GreenlandRobert C Detrano
Apr 9, 2004·Journal of Thoracic Imaging·Jeffrey G SchraginCarl R Fuhrman
Apr 6, 2007·Health Technology Assessment : HTA·S WardN Payne
Apr 5, 2008·Journal of the American College of Cardiology·Allen J TaylorPatrick G O'Malley
Jul 15, 2009·Archives of Internal Medicine·Kwang Pyo KimAmy Berrington de González
Oct 10, 2009·Journal of the American College of Cardiology·Jimmy MachaalanyBenjamin J W Chow
Apr 23, 2010·Journal of the American Academy of Nurse Practitioners·Luann Richardson
Apr 29, 2010·JAMA : the Journal of the American Medical Association·Tamar S PolonskyPhilip Greenland
Apr 1, 2008·Expert Review of Pharmacoeconomics & Outcomes Research·Scott D Grosse
Jul 14, 2010·Journal of the American College of Cardiology·Prediman K Shah
Nov 26, 2010·Circulation·Philip GreenlandUNKNOWN American College of Cardiology Foundation/American Heart Asscoiation Tasl Force on Practice Guidelines
Nov 26, 2010·Circulation·Philip GreenlandUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
May 19, 2011·PharmacoEconomics·Amy K O'SullivanDavid Thompson
Oct 11, 2011·Journal of the American College of Cardiology·Bob J H van KempenM G Myriam Hunink
Oct 13, 2011·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Marcello TonelliUNKNOWN Alberta Kidney Disease Network
May 15, 2012·The American Journal of Cardiology·Allan D SnidermanCurt D Furberg
Jan 22, 2014·Circulation·Alan S GoUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Mar 13, 2014·Circulation. Cardiovascular Quality and Outcomes·Mark J PletcherPhilip Greenland
Apr 1, 2014·Journal of the American College of Cardiology·Seth S MartinMichael J Blaha
May 13, 2014·Journal of the American College of Cardiology·Nivee P AminErin D Michos
Jul 19, 2014·BMJ : British Medical Journal·Chintan S DesaiRoger S Blumenthal

❮ Previous
Next ❯

Citations

Feb 20, 2016·Progress in Cardiovascular Diseases·Abdul H QaziJames H O'Keefe
Dec 10, 2015·PharmacoEconomics·Alexander ThompsonKatherine Payne
May 8, 2016·The American Journal of Medicine·Catherine S BennetJohn W McEvoy
Jan 17, 2017·Annales d'endocrinologie·UNKNOWN French Society of Endocrinology (SFE)B Vergès
Mar 11, 2017·JACC. Cardiovascular Imaging·Darryl P LeongSalim Yusuf
May 8, 2018·Expert Review of Cardiovascular Therapy·Christian TescheChristian Thilo
Jan 27, 2017·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Sep 10, 2015·Circulation. Cardiovascular Quality and Outcomes·Khurram Nasir
Dec 18, 2015·Circulation·UNKNOWN Writing Group MembersUNKNOWN Stroke Statistics Subcommittee
Feb 2, 2018·Circulation·Emelia J BenjaminUNKNOWN American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee
Sep 28, 2017·Current Treatment Options in Cardiovascular Medicine·Sina KianoushMichael J Blaha
Nov 23, 2019·Current Atherosclerosis Reports·Hong Loan NguyenTina Shah
Feb 21, 2019·The Journal of Clinical Endocrinology and Metabolism·David S Schade, R Philip Eaton
Sep 25, 2020·La Radiologia medica·Maurizio CentonzeFrancesco De Cobelli
Jul 14, 2020·SAGE Open Medicine·Aldo Javier Vázquez MézquitaMaría Nayeli Vázquez Sánchez
Sep 2, 2016·Diabetes Technology & Therapeutics·Mark R BurgeDavid S Schade
Aug 11, 2020·Cost Effectiveness and Resource Allocation : C/E·Yibo XieRui Zhang
Sep 27, 2018·Current Treatment Options in Cardiovascular Medicine·Mahmoud Al RifaiMichael J Blaha
Nov 11, 2019·The International Journal of Cardiovascular Imaging·Philip BraininTor Biering-Sørensen
Dec 14, 2019·Advances in Chronic Kidney Disease·Edward R SmithStephen G Holt
Jan 18, 2021·JACC. Cardiovascular Imaging·Prasanna VenkataramanUNKNOWN CAUGHT-CAD investigators
Mar 22, 2020·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Roberta AraJohn Brazier
Mar 30, 2021·Radiology. Cardiothoracic Imaging·Olufunmilayo H ObisesanMichael J Blaha

❮ Previous
Next ❯

Methods Mentioned

BETA
pharmacotherapy

Clinical Trials Mentioned

NCT00005487

Software Mentioned

TreeAge Pro

Related Concepts

Related Feeds

ApoE, Lipids & Cholesterol

Serum cholesterol, triglycerides, apolipoprotein B (APOB)-containing lipoproteins (very low-density lipoprotein (VLDL), immediate-density lipoprotein (IDL), and low-density lipoprotein (LDL), lipoprotein A (LPA)) and the total cholesterol/high-density lipoprotein (HDL) cholesterol ratio are all connected in diseases. Here is the latest research.

Biomarkers for Cardiovascular Risk Assessment

Sensitive and accurate biomarkers used in cardiovascular risk prediction can potentially be used to manage the risk of cardiovascular disease. Discover the latest research on Biomarkers for Cardiovascular Risk Assessment here. Discover the latest research on Biomarkers for Cardiovascular Risk Assessment here.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.