Related Experiment Video

Updated: Oct 4, 2025

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

557

Cost-Effectiveness Analysis of CCTA in SUS, as Compared to Other Non-Invasive Imaging Modalities in Suspected

Patricia Bastos do Carmo1, Carlos Alberto da Silva Magliano1, Helena Cramer Veiga Rey1

  • 1Instituto Nacional de Cardiologia , Rio de Janeiro , RJ - Brasil.

Arquivos Brasileiros De Cardiologia
|February 9, 2022
PubMed

Insights

Computed tomography angiography (CTA) could be a cost-effective strategy for diagnosing coronary artery disease (CAD) in Brazil. This analysis ranks diagnostic tests, finding CTA combined with other methods to be most efficient for intermediate-risk patients.

Area of Science:

  • Health Technology Assessment
  • Cost-Effectiveness Analysis
  • Diagnostic Strategy Optimization

Background:

  • The Brazilian public health system currently excludes computed tomography angiography (CTA) from its diagnostic services.
  • Coronary artery disease (CAD) diagnosis requires efficient and cost-effective strategies within public health frameworks.

Purpose of the Study:

  • To rank the cost-effectiveness of various diagnostic strategies for coronary artery disease (CAD) in Brazil.
  • To evaluate the inclusion of computed tomography angiography (CTA) in diagnostic pathways for intermediate pre-test probability patients.

Main Methods:

  • A decision tree model was employed for cost-effectiveness analysis.
  • Incremental cost-effectiveness ratio (ICER) and net benefit were calculated using varying willingness-to-pay thresholds.
  • Sequential diagnostic testing was modeled, with confirmatory tests only initiated after a positive initial result.

Main Results:

  • The efficiency frontier identified three key strategies: exercise tests (ET) alone, ET followed by stress echocardiography (SE), and SE followed by CTA.
  • The strategy of stress echocardiography followed by computed tomography angiography (SE-CTA) emerged as the most cost-effective.
  • The ranking of cost-effectiveness varied based on the willingness-to-pay threshold.

Conclusions:

  • This study provides a ranked decision-making framework for CAD diagnostic strategies in intermediate-risk populations within the Brazilian public health system.
  • Including CTA in the diagnostic arsenal is projected to be a cost-effective strategy across most evaluated scenarios, even with feasible cost estimations.
  • The findings support the potential integration of CTA into public health strategies for CAD diagnosis.
Abstract

More Related Videos

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.4K
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.3K

Related Concept Videos

Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
88
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
36
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
148
Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
311
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
56
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
44