ArticleJournal of the American Heart Association2025
Cost-Effectiveness of Coronary Artery Calcium Scoring for Cardiovascular Disease Prevention in Diabetes: An Analysis From MESA.
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.
What it found
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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.
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.
Who cites it
1 citing paper in PubMed.
- Coronary Calcium Scoring in Diabetes: Recalibrating Cardiovascular Risk in 2025.Journal of diabetes · 2025Article
Corrections and comments
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Authors and funding
6 authors.
Funding
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.
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Registered trials
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