Evidence map›Paper›PMID 40879032›Full record

ArticleJournal of the American Heart Association2025

Cost-Effectiveness of Coronary Artery Calcium Scoring for Cardiovascular Disease Prevention in Diabetes: An Analysis From MESA.

Bart S Ferket, M G Myriam Hunink, Umesh Masharani, Wendy Max, Joseph Yeboah, Kirsten E Fleischmann

Abstract read
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Bart S FerketInstitute for Healthcare Delivery Science, Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY USA.ORCID 0000-0003-2754-545X
M G Myriam HuninkDepartment of Epidemiology and Radiology Erasmus MC Rotterdam The Netherlands.ORCID 0000-0002-2942-2798
Umesh MasharaniDepartment of Medicine University of California San Francisco CA USA.ORCID 0000-0002-3269-804X
Wendy MaxInstitute for Health & Aging and Department of Social and Behavioral Sciences University of California San Francisco CA USA.ORCID 0000-0002-4040-1592
Joseph YeboahHeart and Vascular Center of Excellence Wake Forest Baptist Health Winston Salem NC USA.ORCID 0000-0001-6274-5882
Kirsten E FleischmannDivision of Cardiology and Department of Medicine University of California San Francisco CA USA.ORCID 0000-0002-3813-4384

Funding

Task Area A Core Study Operations.Task Area A shall encompass annual follow-up of cohort members, clinical endpoints ascertainment, study coordination activities, maintenance of the database and biosp75N92020D00001 · NHLBI · UNIVERSITY OF WASHINGTON · PI MCCLELLAND, ROBYN LEAGH · 2020 to 2025
$17.2M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00005 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI WATSON, KAROL E · 2020 to 2025
$5.1M
TO EXERCISE OPTION PERIOD ONE (1) FOR TASK AREA A - MESA CORE OPERATIONS, FIELD CENTER.75N92020D00004 · NHLBI · NORTHWESTERN UNIVERSITY · PI SIEGEL, JONATHAN H · 2020 to 2025
$4.5M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00006 · NHLBI · UNIVERSITY OF MINNESOTA · PI PANKOW, JAMES S · 2020 to 2025
$4.4M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00003 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI POST, WENDY S · 2020 to 2025
$3.8M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00007 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI BERTONI, ALAIN GERALD · 2020 to 2025
$3.5M
Task Area A shall encompass annual follow-up of cohort members, clinical events investigations, study operations, and data analysis and manuscript writing. If implemented, Task A.1 will provide fundin75N92020D00002 · NHLBI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHEA, STEVEN J · 2020 to 2025
$3.4M
NHLBI NIH HHS 75N92020D00001NHLBI NIH HHS 75N92020D00002NHLBI NIH HHS 75N92020D00003NHLBI NIH HHS 75N92020D00004NHLBI NIH HHS 75N92020D00005NHLBI NIH HHS 75N92020D00006NHLBI NIH HHS 75N92020D00007
6 · The paper itself

Abstract

backgroundCoronary artery calcium scoring (CACS) by computed tomography could enhance risk assessment and decision making for preventive medication in patients with diabetes. We performed a microsimulation study to compare costs and health outcomes of guideline-based periodic cardiovascular risk assessment with and without CACS.

methodsWe modeled various US guideline-based preventive approaches based on periodically assessed 10-year risk by pooled cohort equations with and without CACS. We predicted cumulative costs and quality-adjusted life years (QALYs) until age 100 years from the US health care sector perspective in MESA (Multi-Ethnic Study of Atherosclerosis) participants aged 45 to 84 years with diabetes (n=853), who were weighted to represent the US general patient population. Probabilistic and deterministic sensitivity analyses were performed to address uncertainty.

resultsInitiating high-intensity statins regardless of risk and low-dose aspirin if 10-year risk ≥10% led to the largest QALY gains with incremental cost-effectiveness ratios of $35 000 to $40 000/QALY. When omitting such universal approaches, allocating high-intensity statins and low-dose aspirin if CACS ≥100 led to incremental cost-effectiveness ratios around $50 000/QALY. Ranking of strategies by cost-effectiveness was generally robust against parameter uncertainty. The incremental cost-effectiveness ratio of the CACS ≥100 strategy fell below $50 000/QALY if the fee of CACS fell below $75 or when statin continuation was assumed to significantly improve with nonzero CAC scores.

conclusionsBroadening the use of high-intensity statins and low-dose aspirin in patients aged 45 to 84 years with diabetes can be considered cost-effective. If broad-scale use of intensive preventive treatment is either not feasible or not desired, then CACS may be cost-effective in refining preventive treatment decisions.

Indexed as

Cardiovascular DiseasesComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseCoronary VesselsDiabetes MellitusVascular CalcificationAgedAged, 80 and overAspirinCost-Benefit AnalysisFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedAspirinHydroxymethylglutaryl-CoA Reductase Inhibitorscoronary calciumcost‐effectivenessdiabetespreventionrisk assessment

Identifiers

PMID40879032
PMCPMC12553458

What Socratic holds

Texttitle and abstract
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.