000165346 001__ 165346
000165346 005__ 20260107201858.0
000165346 0247_ $$2doi$$a10.1177/2047487319873149
000165346 0248_ $$2sideral$$a146828
000165346 037__ $$aART-2020-146828
000165346 041__ $$aeng
000165346 100__ $$aCrespo C.
000165346 245__ $$aOptimisation of cardiac resynchronisation therapy device selection guided by cardiac magnetic resonance imaging: Cost-effectiveness analysis
000165346 260__ $$c2020
000165346 5060_ $$aAccess copy available to the general public$$fUnrestricted
000165346 5203_ $$aBackground
A recent study showed that the presence and characteristics of myocardial scar could independently predict appropriate implantable cardioverter-defibrillator therapies and the risk of sudden cardiac death in patients receiving a de novo cardiac resynchronisation device.
Design
The aim was to evaluate the cost-effectiveness of cardiac magnetic resonance imaging-based algorithms versus clinical practice in the decision-making process for the implantation of a cardiac resynchronisation device pacemaker versus cardiac resynchronisation device implantable cardioverter-defibrillator device in heart failure patients with indication for cardiac resynchronisation therapy.
Methods
An incidental Markov model was developed to simulate the lifetime progression of a heart failure patient cohort. Key health variables included in the model were New York Heart Association functional class, hospitalisations, sudden cardiac death and total mortality. The analysis was done from the healthcare system perspective. Costs (€2017), survival and quality-adjusted life years were assessed.
Results
At 5-year follow-up, algorithm I reduced mortality by 39% in patients with a cardiac resynchronisation device pacemaker who were underprotected due to misclassification by clinical protocol. This approach had the highest quality-adjusted life years (algorithm I 3.257 quality-adjusted life years; algorithm II 3.196 quality-adjusted life years; clinical protocol 3.167 quality-adjusted life years) and the lowest lifetime costs per patient (€20,960, €22,319 and €28,447, respectively). Algorithm I would improve results for three subgroups: non-ischaemic, New York Heart Association class III–IV and ≥65 years old. Furthermore, implementing this approach could generate an estimated €702 million in health system savings annually in European Society of Cardiology countries.
Conclusion
The application of cardiac magnetic resonance imaging-based algorithms could improve survival and quality-adjusted life years at a lower cost than current clinical practice (dominant strategy) used for assigning cardiac resynchronisation device pacemakers and cardiac resynchronisation device implantable cardioverter-defibrillators to heart failure patients.
000165346 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/
000165346 590__ $$a7.804$$b2020
000165346 591__ $$aCARDIAC & CARDIOVASCULAR SYSTEMS$$b18 / 141 = 0.128$$c2020$$dQ1$$eT1
000165346 592__ $$a1.669$$b2020
000165346 593__ $$aEpidemiology$$c2020$$dQ1
000165346 593__ $$aCardiology and Cardiovascular Medicine$$c2020$$dQ1
000165346 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/acceptedVersion
000165346 700__ $$aLinhart M.
000165346 700__ $$aAcosta J.
000165346 700__ $$aSoto-Iglesias D.
000165346 700__ $$aMartínez M.
000165346 700__ $$0(orcid)0000-0001-9187-1773$$aJáuregui B.
000165346 700__ $$aMira Á.
000165346 700__ $$aRestovic G.
000165346 700__ $$aSagarra J.
000165346 700__ $$aAuricchio A.
000165346 700__ $$aFahn B.
000165346 700__ $$aBoltyenkov A.
000165346 700__ $$aLasalvia L.
000165346 700__ $$aSampietro-Colom L.
000165346 700__ $$aBerruezo A.
000165346 773__ $$g27, 6 (2020), 622-632$$pEur. j. prev. cardiol.$$tEuropean Journal of Preventive Cardiology$$x2047-4873
000165346 8564_ $$s5073195$$uhttps://zaguan.unizar.es/record/165346/files/texto_completo.pdf$$yPostprint
000165346 8564_ $$s1150843$$uhttps://zaguan.unizar.es/record/165346/files/texto_completo.jpg?subformat=icon$$xicon$$yPostprint
000165346 909CO $$ooai:zaguan.unizar.es:165346$$particulos$$pdriver
000165346 951__ $$a2026-01-07-18:52:51
000165346 980__ $$aARTICLE