February 26, 2013Journal of Hypertension
Long-term health benefits and costs of measurement of carotid intima–media thickness in prevention of coronary heart disease
Key result
CIMT measurement yields ~1-3% lower absolute MI risk and increased QALYs vs standard risk scoring.
Why the study?
The cost-effectiveness of carotid intima-media thickness (CIMT) measurements for primary prevention of coronary heart disease was previously unknown.
Does CIMT measurement improve cost-effectiveness and health outcomes in asymptomatic individuals aged 50-59 at intermediate or high CHD risk?
Population
Hypothetical cohort of men and women aged 50-59 years at intermediate or high CHD risk
Comparison
CIMT measurement for cardiovascular risk stratification vs standard risk stratification
Design
Markov model simulation based on Atherosclerosis Risk in Communities Study data
Follow-up
10 to 30 years
Authors
Discussion
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Member takes
Implication
May support long-term CIMT use for risk stratification in women; leaves open routine adoption pending prospective trials.
Structured PICO
Does CIMT measurement improve cost-effectiveness and health outcomes in asymptomatic individuals aged 50-59 at intermediate or high CHD risk?
P
Population
A hypothetical cohort of men and women aged 50-59 years at intermediate or high CHD risk, simulated over a 20-30 year period.
I
Intervention
Carotid intima-media thickness (CIMT) measurement for cardiovascular risk stratification
C
Comparator
Standard risk stratification (Framingham risk score)
O
Outcome
Cost-effectiveness (absolute risk of MI, quality-adjusted life years [QALYs], and costs)
CIMT measurement for cardiovascular risk stratification in asymptomatic individuals aged 50-59 years is cost-effective over the long term, particularly for women.
Cite This Study
Ruijter et al. (2013) studied Coronary heart disease. Carotid intima-media thickness (CIMT) measurement was evaluated on Myocardial infarction (MI) events and quality-adjusted life years (QALYs). CIMT measurements for cardiovascular risk stratification in asymptomatic individuals aged 50-59 years resulted in a 1-3% lower absolute risk of MI and increased QALYs over 20-30 years.