Highlights
- •Patients with access to cardiac PET/CT are not representative of the patient population most likely to have CS in this limited study evaluation.
- •Cardiac PET/MR has long-term cost-effectiveness compared to the standard of care imaging of cardiac MR followed by cardiac PET/CT sequentially.
- •Same day cardiac PET/MR had overall improved quality of life-years for CS patients compared to the standard of care.
Abstract
Importance
Cardiac sarcoidosis is associated with a high mortality rate. Given multiple barriers
to obtaining cardiac PET imaging, we suspect individuals with access to this imaging
modality are not representative of the Sarcoid patient population, which in the United
States are predominantly Black females.
Objective
To evaluate the demographics of patients with cardiac PET access and the cost-effectiveness
of cardiac PET/MR imaging relative to standard of care.
Design
This is a retrospective, observational study. The demographic information of patients
with suspected cardiac sarcoidosis and cardiac PET/CT imaging within a national registry
of sarcoidosis were reviewed (n = 4561). An individual-level, continuous, time-state transition model was used for
the evaluation of long-term cost-effectiveness for the combined cardiac PET/MR compared
to standard of care cardiac MR followed by cardiac PET/CT.
Results
Patients who underwent cardiac PET in the national registry had 88.35% higher odds
of being male (p < 0.001) and 43.82% higher odds of being White (p = 0.003) than their counterparts who did not have cardiac PET imaging. Combined cardiac
PET/MR had overall lower total lifetime costs ($8761 vs $10,777) and overall improved
expected quality of life-years compared to the standard of care (0.77 vs 0.69).
Conclusion and relevance
The findings suggest that patients with access to cardiac PET/CT are not representative
of the patient population most likely to have cardiac sarcoidosis in this limited
study evaluation. Universal insurance coverage should be considered for Cardiac PET
imaging as same day cardiac PET and MR imaging has potential long-term cost and quality
of life benefit.
Keywords
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Article info
Publication history
Published online: December 01, 2022
Accepted:
November 28,
2022
Received in revised form:
November 8,
2022
Received:
July 16,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
