Induced Cardiovascular Procedural Costs and Resource Consumption Patterns After Coronary Artery Calcium ScreeningResults From the EISNER (Early Identification of Subclinical Atherosclerosis by Noninvasive Imaging Research) Study
Leslee J. Shaw, PhD*,
James K. Min, MD ,
Matthew Budoff, MD ,
Heidi Gransar, MS ,
Alan Rozanski, MD||,
Sean W. Hayes, MD,
John D. Friedman, MD,
Romalisa Miranda, MPH,
Nathan D. Wong, PhD¶ and
Daniel S. Berman, MD,*
* Emory University School of Medicine, Atlanta, Georgia
Weill Medical College of Cornell University, The New York Presbyterian Hospital, New York, New York
Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, California
Cedars-Sinai Medical Center, Los Angeles, California
|| St. Luke's Roosevelt Hospital, New York, New York
¶ University of California at Irvine, Irvine, California
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Figure 1 Downstream Stress Imaging and CCTA Rates After CAC
(A) Cumulative rates of follow-up stress echocardiography or myocardial perfusion single-photon emission computed tomography at years 1, 2, 4, and 6 in coronary artery calcium (CAC) subsets. The numbers in parentheses represent the number of patients available at each follow-up time point. *Subset analysis by CAC = 0 versus 1 to 10 revealed identical follow-up rates for coronary angiography. (B) Cumulative rates of follow-up coronary computed tomographic angiography (CCTA) at years 1, 2, 4, and 6 in CAC subsets. *The number of patients available is the same as listed in (A).
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Figure 2 Downstream Invasive Angiography Rates and Probability of Angiography After CAC
(A) Cumulative rates of follow-up ICA at years 1, 2, 4, and 6 in CAC subsets. *The number of patients available is the same as listed in Figure 1A. The above curve is calculated with the exclusion of 34 previous hospitalizations for acute coronary syndromes or stroke. Plotting of the results excluding previous hospitalization for acute coronary syndrome or stroke did not change the presented results. (B) Probability of ICA across the range of CAC scores. The call-out boxes indicate the odds ratio (95% confidence intervals) for coronary angiography at 4 years for CAC scores >100. The odds of coronary angiography were not significant for scores of 1 to 10 (p < 0.37) or 11 to 100 (p = 0.11). ICA = invasive coronary angiography; other abbreviations as in Figure 1.
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Figure 3 Event-Free Survival by CAC and FRS
Cumulative event-free survival in CAC and Framingham Risk Score (FRS) subsets. Included in each survival curve is a table of the hazard ratios (HRs) (95% confidence intervals [CIs]). *FRS-adjusted HR data. Abbreviations as in Figure 1.
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