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Updated: Oct 6, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Cost-Minimization Analysis for Cardiac Revascularization in 12 Health Care Systems Based on the EuroCMR/SPINS
Karine Moschetti1, Raymond Y Kwong2, Steffen E Petersen3
1Health Technology Assessment Unit, University Hospital of Lausanne, Lausanne, Switzerland; Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.
A noninvasive cardiac magnetic resonance (CMR) guided strategy significantly reduces healthcare costs compared to invasive methods like coronary angiography (CXA) with or without fractional flow reserve (FFR). This cost-effectiveness applies across all patient risk levels.
Area of Science:
- Cardiovascular Imaging
- Health Economics
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) poses a significant public health challenge.
- Stress perfusion cardiac magnetic resonance (CMR) offers high accuracy in detecting CAD.
- Despite guidelines, noninvasive testing adherence for stable CAD patients remains suboptimal.
Purpose of the Study:
- To compare the economic impact of a noninvasive CMR-guided strategy against two invasive approaches: coronary angiography (CXA) with fractional flow reserve (FFR) and CXA alone.
- To evaluate cost-effectiveness across diverse patient risk profiles for CAD diagnosis and management.
Main Methods:
- Analysis of cost data from the EuroCMR and SPINS registries, encompassing 12 global healthcare systems.
- Inclusion of costs for diagnostic tests (CMR, CXA with/without FFR), revascularizations, and 1-year follow-up complications.
- Comparison of a CMR-guided strategy (CMR+CXA) with hypothetical CXA+FFR and CXA-only invasive strategies.
Main Results:
- The CMR+CXA strategy demonstrated significant cost savings compared to the CXA+FFR strategy across all 12 healthcare systems.
- Cost savings were substantial, ranging from 31% to 52% in low- to high-risk patients.
- Even greater cost reductions were observed when comparing CMR+CXA to CXA-only, with savings between 52% and 73%.
Conclusions:
- A cardiac magnetic resonance (CMR)-guided strategy offers consistent and significant cost savings compared to invasive fractional flow reserve (FFR) guided strategies.
- The noninvasive CMR approach proves highly cost-effective across the full spectrum of patient risk for diagnosing coronary artery disease.
- Implementing CMR-guided strategies can lead to substantial economic benefits in cardiovascular healthcare systems globally.
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