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Published on 12.04.2017
Table 1: Baseline characteristics, prevalence of risk and average total plaque area for Switzerland and Germany. | ||||||
Baseline Characteristics | Switzerland | Germany | ||||
Number of subjects (n) | 2203 | 2942 | ||||
Female (n, %) | 1083 | 49% | 989 | 34% | ||
Age, years (mean ± 1 SD) | 57 | ± | 9 | 46 | ± | 10 |
Family history of CAD (n, %) | 386 | 18% | 660 | 22% | ||
Current smoker (n, %) | 458 | 21% | 770 | 26% | ||
Blood pressure systolic, mm Hg (mean ± 1 SD) | 129 | ± | 16 | 123 | ± | 16 |
TPA mm2 (mean ± 1 SD) | 52 | ± | 50 | 36 | ± | 50 |
Individuals with TPA ≥80 mm2 (n, %) | 484 | 22% | 452 | 15% | ||
Total cholesterol, mmol/l (mean ± 1 SD) | 5.9 | ± | 1.2 | 5.9 | ± | 1.2 |
HDL cholesterol, mmol/l (mean ± 1 SD) | 1.5 | ± | 0.5 | 1.4 | ± | 0.4 |
LDL cholesterol, mmol/l (mean ± 1 SD) | 3.7 | ± | 1.0 | 3.8 | ± | 0.9 |
Triglycerides, mmol/l (mean ± 1 SD) | 1.5 | ± | 0.9 | 1.7 | ± | 1.2 |
SCORE average risk in 10 years (% ± 1 SD) | 1.5 | ± | 1.7 | 0.6 | ± | 0.3 |
PROCAM average risk in 10 years (% ± 1 SD) | 6.2 | ± | 7.4 | 4.3 | ± | 3.5 |
AGLA average risk in 10 years (% ± 1 SD) | 4.3 | 5.2 | – | |||
CAD = coronary artery disease; HDL = high-density lipoprotein; LDL = low density lipoprotein; SD = standard deviation; TPA = total plaque area |
Table 2: Cost per quality adjusted life year (QALY) for 5 and 10 years and for different levels of coronary risk [8], with relative risk reductions of 30% and 22%. | |||||||||
Relative risk reduction 30% | Relative risk reduction 22% | ||||||||
SMB cost/QALY model | 5 years | 10 years | 5 years | 10 years | |||||
Fatal event | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | 1.0 | |
Nonfatal event | 4.5 | 4.5 | 4.5 | 4.5 | 4.5 | 4.5 | 4.5 | 4.5 | |
Cost of fatal event | 8500 | 8500 | 8500 | 8500 | 8500 | 8500 | 8500 | 8500 | |
Cost of nonfatal event (1st year) | 25 000 | 25 000 | 25 000 | 25 000 | 25 000 | 25 000 | 25 000 | 25 000 | |
Cost of nonfatal event (after 1st year) | 8000 | 8000 | 8000 | 8000 | 8000 | 8000 | 8000 | 8000 | |
Statin and monitoring cost (per year) | 470 | 470 | 470 | 470 | 470 | 470 | 470 | 470 | |
Effect [(improvement of life) * (quality)] | 13.0 | 71.3 | 142.5 | 213.8 | 9.5 | 52.3 | 104.5 | 156.8 | |
Total cost (per 1000 individuals) | 477 750 | 1 987 500 | 3 975 000 | 5 962 500 | 350 350 | 1 457 500 | 2 915 000 | 4 372 500 | |
Total cost (per individual) | 478 | 1988 | 3975 | 5963 | 350 | 1458 | 2915 | 4373 | |
Statin and monitoring cost (observation years) | 2350 | 4700 | 4700 | 4700 | 2350 | 4700 | 4700 | 4700 | |
Avoided health care costs | 1872 | 2713 | 725 | –1263 | 2000 | 3243 | 1785 | 328 | |
Cost:efficiency ratio (cost per QALY) | 144 380 | 38 070 | 5088 | –5906 | 210 279 | 62 057 | 17 081 | 2089 | |
Fatal risk in % in years | 0.91 | 2.50 | 5.00 | 7.50 | 0.91 | 2.50 | 5.00 | 7.50 | |
Number of individuals | 1000 | 1000 | 1000 | 1000 | 1000 | 1000 | 1000 | 1000 | |
Expected fatal events | 9 | 25 | 50 | 75 | 9 | 25 | 50 | 75 | |
Expected nonfatal events | 41 | 113 | 225 | 338 | 41 | 113 | 225 | 338 | |
Total number of events (fatal + nonfatal) | 50 | 138 | 275 | 413 | 50 | 138 | 275 | 413 | |
Avoidable fatal events | 2.7 | 8 | 15 | 23 | 2.0 | 5.5 | 11.0 | 16.5 | |
Avoidable nonfatal events | 12.3 | 33.8 | 67.5 | 101.3 | 9.0 | 24.8 | 49.5 | 74.3 | |
Total number of avoidable events | 15.0 | 41.3 | 82.5 | 123.8 | 11.0 | 30.3 | 60.5 | 90.8 | |
Absolute risk | 5.0 | 14 | 28 | 41 | 5.0 | 14 | 28 | 41 | |
Avoidable risk | 1.5 | 4 | 8 | 12 | 1.1 | 3 | 6 | 9 | |
Number needed to treat | 67 | 24 | 12 | 8 | 91 | 33 | 17 | 11 |
Table 3: Coronary risk categories for SCORE by age groups, by the distribution of subjects with total plaque area ≥80 mm2 (TPA80) and by country (Switzerland, n = 2124, or Germany, n = 2280). | |||||||||
CH-SCORE % | 40–55 (n) | TPA80 (n) | TPA80 (%) | 56–65 (n) | TPA80 (n) | TPA80 (%) | 65–75 (n) | TPA80 (n) | TPA80 (%) |
0.00–0.99 | 706 | 55 | 8 | 288 | 27 | 9 | 12 | 3 | 25 |
1.00–2.49 | 171 | 31 | 18 | 377 | 108 | 29 | 129 | 42 | 33 |
2.50–4.99 | 26 | 10 | 38 | 141 | 62 | 44 | 181 | 89 | 49 |
5.00–7.49 | 2 | 1 | 50 | 20 | 8 | 40 | 41 | 25 | 61 |
7.50+ | 0 | 0 | 0 | 7 | 5 | 71 | 23 | 16 | 70 |
Total | 905 | 97 | 11 | 833 | 210 | 25 | 386 | 175 | 45 |
DE-SCORE % | 40–55 (n) | TPA80 (n) | TPA80 (%) | 56–65 (n) | TPA80 (n) | TPA80 (%) | |||
0.00–0.99 | 1397 | 99 | 7 | 137 | 31 | 23 | |||
1.00–2.49 | 292 | 91 | 31 | 266 | 104 | 39 | |||
2.50–4.99 | 37 | 28 | 76 | 123 | 73 | 59 | |||
5.00–7.49 | 3 | 3 | 100 | 18 | 14 | 78 | |||
7.50+ | 1 | 1 | 0 | 6 | 5 | 0 | |||
Total | 1730 | 222 | 13 | 550 | 227 | 41 |
Table 4: Sensitivity of various SCORE thresholds to detect TPA80 in those aged 40–65 years, for Switzerland and Germany separately. | |||
SCORE threshold CH | 2.50% | 5.00% | 7.50% |
True positives (n) | 86 | 14 | 5 |
False negatives (n) | 221 | 146 | 302 |
Sensitivity (%) | 28% | 9% | 2% |
SCORE threshold DE | 2.50% | 5.00% | 7.50% |
True positives (n) | 124 | 23 | 6 |
False negatives (n) | 325 | 426 | 443 |
Sensitivity (%) | 28% | 5% | 1% |
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