冠状动脉 (CAC) 成像作为诊断测试:保险覆盖的影响
Morteza Naghavi1, Nathan D Wong2, Michael V McConnell3
1Society for Heart Attack Prevention and Eradication (SHAPE), Houston, Texas, USA.
JACC. Cardiovascular imaging
|December 11, 2025
概括
冠状动脉 (CAC) 图像检测可以在无症状患者中检测到早期冠状动脉疾病 (CAD). 尽管有指导方针建议CAC扫描用于风险评估,但许多付款人拒绝提供保险,阻碍了心脏病发作和中风的诊断和预防.
科学领域:
- 心脏病学 心脏病学
- 预防医学 预防医学
- 医疗成像医学成像
背景情况:
- 动脉样性心血管疾病 (ASCVD) 是全球主要的死亡原因,通常作为心脏病发作或中风等第一个急性事件出现.
- 无症状冠状动脉疾病 (CAD) 的早期诊断和治疗对于预防死亡至关重要.
- 冠状动脉 (CAC) 成像已被证明有效地识别亚临床CAD并预测传统风险因素之外的不良结果.
研究的目的:
- 强调CAC成像在患有ASCVD风险的无症状个体的诊断实用性.
- 倡导遵守当前的ASCVD预防指南,以支付者提供CAC成像覆盖.
- 突出CAC成像在促进共享决策和个性化治疗CAD中的作用.
主要方法:
- 审查和综合现有研究,证明CAC成像的诊断和预后价值.
- 分析当前的ASCVD预防指南和付款人覆盖政策.
- 专注于CAC成像对无症状个体的诊断应用.
主要成果:
- CAC成像有效诊断亚临床CAD,并预测心血管事件,超过传统的风险因素.
- 目前的指导方针建议中等风险人群进行CAC成像,但付款人没有保险导致诊断不足.
- 缺乏医疗保险可以防止及时诊断和治疗,从而导致可预防的心血管事件.
结论:
- 遵守ASCVD指南和扩大CAC成像支付人覆盖范围对于早期CAD检测和预防至关重要.
- CAC成像可以根据亚临床CAD的严重程度制定个性化治疗策略.
- 实施推的CAC成像实践可以减少昂贵和致命的心血管事件的发生率.
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