Cost-effectiveness of continuous real-time intracardiac recurrent event detection and alerting in high-risk acute coronary syndrome patients.

IF 1 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Future cardiology Pub Date : 2025-02-01 Epub Date: 2025-01-31 DOI:10.1080/14796678.2025.2457831
Gillian D Sanders Schmidler, M Sasha John, Jeffrey D Voigt, Mitchell W Krucoff
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Abstract

Background: ALERTS was a pivotal randomized clinical trial (RCT) evaluating an intracardiac monitor with real-time alerting in high-risk acute coronary syndrome patients. The cost-effectiveness however is unknown.

Method: A decision model estimated health effects and costs of implanting a Guardian device in a target patient population, compared to current standard-of-care (SOC). Health and economic outcomes were modeled using ALERTS trial results and relevant literature.

Results: Base-case analysis indicated an incremental lifetime cost of $21,988 with Guardian as compared to SOC (increase of 0.18 life years or 0.37 quality-adjusted life years (QALY)). The incremental cost-effectiveness ratio (ICER) was $121,056/LY or $58,668/QALY.

Conclusion: Real-time intracardiac monitoring with patient alerting was cost-effective using conventional thresholds in acute coronary syndrome (ACS) patients at high-risk for recurrent events.

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高风险急性冠状动脉综合征患者持续实时心内复发事件检测和预警的成本-效果。
背景:ALERTS是一项关键的随机临床试验(RCT),评估在高危急性冠状动脉综合征患者中实时报警的心内监护仪。然而,成本效益是未知的。方法:一个决策模型估计了在目标患者人群中植入监护装置的健康影响和成本,并与目前的标准护理(SOC)进行了比较。使用ALERTS试验结果和相关文献对健康和经济结果进行建模。结果:基础病例分析表明,与SOC相比,使用Guardian的生命周期成本增加了21988美元(增加0.18生命年或0.37质量调整生命年(QALY))。增量成本效益比(ICER)为121,056美元/LY或58,668美元/QALY。结论:对复发事件高风险的急性冠状动脉综合征(ACS)患者,采用常规阈值进行实时心内监测和患者报警具有成本效益。
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来源期刊
Future cardiology
Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
2.80
自引率
5.90%
发文量
87
期刊介绍: Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.
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