Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease

Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in tho...
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Autor*in:	Venkataraman, Prasanna [verfasserIn] Kawakami, Hiroshi [verfasserIn] Huynh, Quan [verfasserIn] Mitchell, Geoffrey [verfasserIn] Nicholls, Stephen J. [verfasserIn] Stanton, Tony [verfasserIn] Tonkin, Andrew [verfasserIn] Watts, Gerald F. [verfasserIn] Marwick, Thomas H. [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	coronary artery calcium score primary prevention risk prediction statins

Übergeordnetes Werk:	Enthalten in: JACC Cardiovascular imaging - American College of Cardiology ; ID: gnd/1017722-X, Amsterdam : Elsevier, 2008, 14, Seite 1206-1217
Übergeordnetes Werk:	volume:14 ; pages:1206-1217

DOI / URN:	10.1016/j.jcmg.2020.11.008

Katalog-ID:	ELV054316944

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520			\|a Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system.
650		4	\|a coronary artery calcium score
650		4	\|a primary prevention
650		4	\|a risk prediction
650		4	\|a statins
700	1		\|a Kawakami, Hiroshi \|e verfasserin \|4 aut
700	1		\|a Huynh, Quan \|e verfasserin \|4 aut
700	1		\|a Mitchell, Geoffrey \|e verfasserin \|4 aut
700	1		\|a Nicholls, Stephen J. \|e verfasserin \|4 aut
700	1		\|a Stanton, Tony \|e verfasserin \|4 aut
700	1		\|a Tonkin, Andrew \|e verfasserin \|4 aut
700	1		\|a Watts, Gerald F. \|e verfasserin \|4 aut
700	1		\|a Marwick, Thomas H. \|e verfasserin \|4 aut
773	0	8	\|i Enthalten in \|a American College of Cardiology ; ID: gnd/1017722-X \|t JACC Cardiovascular imaging \|d Amsterdam : Elsevier, 2008 \|g 14, Seite 1206-1217 \|h Online-Ressource \|w (DE-627)559427239 \|w (DE-600)2412441-2 \|w (DE-576)294402861 \|x 1876-7591 \|7 nnns
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912			\|a GBV_ILN_4012
912			\|a GBV_ILN_4037
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912			\|a GBV_ILN_4126
912			\|a GBV_ILN_4249
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allfields	10.1016/j.jcmg.2020.11.008 doi (DE-627)ELV054316944 (ELSEVIER)S1936-878X(20)31010-X DE-627 ger DE-627 rda eng 610 VZ 44.85 bkl 44.64 bkl Venkataraman, Prasanna verfasserin aut Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system. coronary artery calcium score primary prevention risk prediction statins Kawakami, Hiroshi verfasserin aut Huynh, Quan verfasserin aut Mitchell, Geoffrey verfasserin aut Nicholls, Stephen J. verfasserin aut Stanton, Tony verfasserin aut Tonkin, Andrew verfasserin aut Watts, Gerald F. verfasserin aut Marwick, Thomas H. verfasserin aut Enthalten in American College of Cardiology ; ID: gnd/1017722-X JACC Cardiovascular imaging Amsterdam : Elsevier, 2008 14, Seite 1206-1217 Online-Ressource (DE-627)559427239 (DE-600)2412441-2 (DE-576)294402861 1876-7591 nnns volume:14 pages:1206-1217 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.85 Kardiologie Angiologie VZ 44.64 Radiologie VZ AR 14 1206-1217
spelling	10.1016/j.jcmg.2020.11.008 doi (DE-627)ELV054316944 (ELSEVIER)S1936-878X(20)31010-X DE-627 ger DE-627 rda eng 610 VZ 44.85 bkl 44.64 bkl Venkataraman, Prasanna verfasserin aut Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system. coronary artery calcium score primary prevention risk prediction statins Kawakami, Hiroshi verfasserin aut Huynh, Quan verfasserin aut Mitchell, Geoffrey verfasserin aut Nicholls, Stephen J. verfasserin aut Stanton, Tony verfasserin aut Tonkin, Andrew verfasserin aut Watts, Gerald F. verfasserin aut Marwick, Thomas H. verfasserin aut Enthalten in American College of Cardiology ; ID: gnd/1017722-X JACC Cardiovascular imaging Amsterdam : Elsevier, 2008 14, Seite 1206-1217 Online-Ressource (DE-627)559427239 (DE-600)2412441-2 (DE-576)294402861 1876-7591 nnns volume:14 pages:1206-1217 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.85 Kardiologie Angiologie VZ 44.64 Radiologie VZ AR 14 1206-1217
allfields_unstemmed	10.1016/j.jcmg.2020.11.008 doi (DE-627)ELV054316944 (ELSEVIER)S1936-878X(20)31010-X DE-627 ger DE-627 rda eng 610 VZ 44.85 bkl 44.64 bkl Venkataraman, Prasanna verfasserin aut Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system. coronary artery calcium score primary prevention risk prediction statins Kawakami, Hiroshi verfasserin aut Huynh, Quan verfasserin aut Mitchell, Geoffrey verfasserin aut Nicholls, Stephen J. verfasserin aut Stanton, Tony verfasserin aut Tonkin, Andrew verfasserin aut Watts, Gerald F. verfasserin aut Marwick, Thomas H. verfasserin aut Enthalten in American College of Cardiology ; ID: gnd/1017722-X JACC Cardiovascular imaging Amsterdam : Elsevier, 2008 14, Seite 1206-1217 Online-Ressource (DE-627)559427239 (DE-600)2412441-2 (DE-576)294402861 1876-7591 nnns volume:14 pages:1206-1217 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.85 Kardiologie Angiologie VZ 44.64 Radiologie VZ AR 14 1206-1217
allfieldsGer	10.1016/j.jcmg.2020.11.008 doi (DE-627)ELV054316944 (ELSEVIER)S1936-878X(20)31010-X DE-627 ger DE-627 rda eng 610 VZ 44.85 bkl 44.64 bkl Venkataraman, Prasanna verfasserin aut Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system. coronary artery calcium score primary prevention risk prediction statins Kawakami, Hiroshi verfasserin aut Huynh, Quan verfasserin aut Mitchell, Geoffrey verfasserin aut Nicholls, Stephen J. verfasserin aut Stanton, Tony verfasserin aut Tonkin, Andrew verfasserin aut Watts, Gerald F. verfasserin aut Marwick, Thomas H. verfasserin aut Enthalten in American College of Cardiology ; ID: gnd/1017722-X JACC Cardiovascular imaging Amsterdam : Elsevier, 2008 14, Seite 1206-1217 Online-Ressource (DE-627)559427239 (DE-600)2412441-2 (DE-576)294402861 1876-7591 nnns volume:14 pages:1206-1217 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.85 Kardiologie Angiologie VZ 44.64 Radiologie VZ AR 14 1206-1217
allfieldsSound	10.1016/j.jcmg.2020.11.008 doi (DE-627)ELV054316944 (ELSEVIER)S1936-878X(20)31010-X DE-627 ger DE-627 rda eng 610 VZ 44.85 bkl 44.64 bkl Venkataraman, Prasanna verfasserin aut Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease 2021 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system. coronary artery calcium score primary prevention risk prediction statins Kawakami, Hiroshi verfasserin aut Huynh, Quan verfasserin aut Mitchell, Geoffrey verfasserin aut Nicholls, Stephen J. verfasserin aut Stanton, Tony verfasserin aut Tonkin, Andrew verfasserin aut Watts, Gerald F. verfasserin aut Marwick, Thomas H. verfasserin aut Enthalten in American College of Cardiology ; ID: gnd/1017722-X JACC Cardiovascular imaging Amsterdam : Elsevier, 2008 14, Seite 1206-1217 Online-Ressource (DE-627)559427239 (DE-600)2412441-2 (DE-576)294402861 1876-7591 nnns volume:14 pages:1206-1217 GBV_USEFLAG_U GBV_ELV SYSFLAG_U SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2004 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 44.85 Kardiologie Angiologie VZ 44.64 Radiologie VZ AR 14 1206-1217
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authorswithroles_txt_mv	Venkataraman, Prasanna @@aut@@ Kawakami, Hiroshi @@aut@@ Huynh, Quan @@aut@@ Mitchell, Geoffrey @@aut@@ Nicholls, Stephen J. @@aut@@ Stanton, Tony @@aut@@ Tonkin, Andrew @@aut@@ Watts, Gerald F. @@aut@@ Marwick, Thomas H. @@aut@@
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author	Venkataraman, Prasanna
spellingShingle	Venkataraman, Prasanna ddc 610 bkl 44.85 bkl 44.64 misc coronary artery calcium score misc primary prevention misc risk prediction misc statins Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease
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topic_title	610 VZ 44.85 bkl 44.64 bkl Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease coronary artery calcium score primary prevention risk prediction statins
topic	ddc 610 bkl 44.85 bkl 44.64 misc coronary artery calcium score misc primary prevention misc risk prediction misc statins
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title	Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease
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title_full	Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease
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title_sort	cost-effectiveness of coronary artery calcium scoring in people with a family history of coronary disease
title_auth	Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease
abstract	Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system.
abstractGer	Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system.
abstract_unstemmed	Objectives: To assess the cost effectiveness of coronary artery calcium (CAC) compared with traditional risk factor–based prediction alone in those with an family history of premature coronary artery disease (FHCAD).Background: The use of CAC scoring to guide primary prevention statin therapy in those with a FHCAD is inconsistently recommended in guidelines, and usually not reimbursed by insurance.Methods: A microsimulation model was constructed in TreeAge Healthcare Pro using data from 1,083 participants in the CAUGHT-CAD (Coronary Artery Calcium Score: Use to Guide Management of HerediTary Coronary Artery Disease) trial. Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system.
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title_short	Cost-Effectiveness of Coronary Artery Calcium Scoring in People With a Family History of Coronary Disease
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author2	Kawakami, Hiroshi Huynh, Quan Mitchell, Geoffrey Nicholls, Stephen J. Stanton, Tony Tonkin, Andrew Watts, Gerald F. Marwick, Thomas H.
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Outcomes assessed were quality-adjusted life years (QALYs): cost-effectiveness was assessed over a 15-year time horizon from the perspective of the US health care sector using real-world statin prescribing, accounting for the effect of knowledge of subclinical disease on adherence to guideline-directed therapies. Costs were assessed in 2020 USD, with discounting undertaken at 3%.Results: Statins were indicated in 45% of the cohort using the CAC strategy and 27% using American College of Cardiology/American Heart Association (2019) treatment strategies. Compared with applying a statin treatment threshold of 7.5%, the CAC strategy was more costly ($145) and more effective (0.0097 QALY) with an incremental cost-effective ratio (ICER) of $15,014/QALY. CAC ICER was driven by CAC acquisition and statin prescription cost and improved with certain patient subgroups: male, age >60 years, and 10-year risk pooled cohort equation risk ≥7.5%. CAC scanning of low-risk patients (10-year risk <5%) or those 40 to 50 years of age was not cost-effective.Conclusions: Systematic CAC screening and treatment of those with FHCAD and subclinical disease was more cost-effective than management using statin treatment thresholds, in the US health care system.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">coronary artery calcium score</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">primary prevention</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">risk prediction</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">statins</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Kawakami, Hiroshi</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="1" ind2=" "><subfield code="a">Huynh, Quan</subfield><subfield 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