在CAD诊断协议中优先考虑非侵入性方法的成本节约:系统审查
Ben Kluge1, James Harris2, Irene Sánchez-Collado2
1Bayer AG Pharmaceuticals, Berlin, Germany.
Journal of medical economics
|August 21, 2025
概括
冠状动脉疾病 (CAD) 的非侵入性诊断测试如CCTA和CMR比侵入性导管血管学 (ICA) 更具成本效益. 优先考虑这些非侵入性方法,可以降低低至中等的CAD前测试概率的患者的医疗费用和住院时间.
科学领域:
- 心血管医学
- 健康经济学
- 诊断成像
背景情况:
- 非侵入性CAD诊断的临床益处已知,但与侵入性方法相比,其经济影响尚不清楚.
- 患有低至中等前测试概率 (PTP) 的症状患者需要具有成本效益的诊断策略.
- 了解经济和人文数据可以指导对诊断方式的投资.
研究的目的:
- 审查非侵入性与侵入性CAD诊断方式的健康经济后果.
- 评估经济和人文数据是否可以为CAD诊断提供投资决策.
主要方法:
- 1992年至2023年多个数据库 (MEDLINE,Embase,Cochrane) 的系统审查.
- 包括来自英国,法国,德国,意大利,日本,中国和美国的研究.
- 评估了侵入性 (ICA,ICA-FFR) 和非侵入性 (CCTA,CCTA-FFR,CMR,压力心电图,SPECT,PET,压力回声) 的方法.
主要成果:
- 39个记录报告了相关的结果.
- 在低至中度PTP CAD患者中,与单独的ICA相比,非侵入性治疗方法显示成本节约.
- 非侵袭性方法减少了复血管化和住院时间.
结论:
- 投资于CAD诊断应该有利于冠状动脉计算机断层扫描 (CCTA) 和心血管磁共振 (CMR) 影像.
- 与侵袭性导管血管学 (ICA) 相比,CCTA和CMR具有经济优势.
- 优先考虑先进的非侵入性成像可以优化CAD诊断中的资源配置.
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