An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies

ÖZÇELİK, Nihat; TAŞÇI, Cengiz

An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies

Cengiz TAŞÇI, (Gama Tıp Merkezi, Nükleer Tıp Bölümü, Gaziantep, Türkiye)

Nihat ÖZÇELİK (Gama Tıp Merkezi, Nükleer Tıp Bölümü, Gaziantep, Türkiye)

Molecular Imaging and Radionuclide Therapy

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Yıl: 2011 Cilt: 20 Sayı: 3 Sayfa Aralığı: 75 - 93 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies

Öz:

Koroner kalp hastalığı (KKH), Avrupa’da ve Amerika’da olduğu gibi Türkiye’de de kadın ve erkekler arasında önde gelen ölüm sebebidir. Ülkemizde hastalığın prevalansı %3.8’dir ve her yıl KKH havuzuna ortalama 200 000 hasta eklenmektedir. Türkiye’de daha genç yaşlarda iskemik kalp hastalığına rastlanmaktadır. Türklerin genetik yatkınlığının yanı sıra, toplumumuzda günlük egzersiz alışkanlığının az olması, sigara alışkanlığı ve obezitenin yüksek oranda bulunması gibi nedenler, KKH’nın erken yaşlarda görülmesini etkilemektedir. Hastalığa ayrılan sağlık harcamasının da görece yüksek olması beklenebilir, ancak bir hastalık için yapılan toplam ya da kişi başı sağlık harcaması her zaman o hastalığın toplumdaki prevalansı ile paralel değildir. Bu çalışmada, Türkiye ile bazı Avrupa ülkeleri arasında KKH istatistikleri açısından bir karşılaştırma yapıldı ve miyokard perfüzyon sintigrafisi (MPS)’‘nin koroner anjiyografi öncesinde bir eleyici test olarak kullanılmasının klinik ve ekonomik sonuçları incelendi. Bu sonuçlar ülkemiz açısından da değerlendirildi. Tedavi stratejilerindeki yeni yaklaşımlara paralel olarak revaskülarizasyondan yarar görebilecek yüksek riskli hastaları seçmek için girişimsel olmayan testler önem kazanmıştır. Öte yandan, tanı için hastalara doğrudan anjiyografi yapılmasının, klinik sonuçları değiştirmediği halde yüksek oranlarda revaskülarizasyona yol açtığı görüldüğünden, hasta seçiminde eleyici bir öncü teste ihtiyaç ortaya çıkmıştır. Klinik sonuçları en iyi öngörebilen ekonomik bir test olması dolayısıyla, MPS literatürde, özellikle orta ve yüksek riskli hastalar ile bilinen KKH olanlarda böyle bir rol için önerilmektedir. Anjiyografi öncesinde bir eleyici test olarak kabul edilmesi halinde, MPS Türkiye’de de klinik ve ekonomik sonuçlar açısından mevcut duruma göre daha iyi bir çözüm sağlayabilir. (MIRT 2011;20:75-93)

Anahtar Kelime:

Konular: Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme

Koroner kalp hastalığına genel bakış (Türkiye ile Avrupa arasında bir karşılaştırma) ve tanısal stratejilerin maliyet etkinliği

Öz:

Coronary heart disease (CHD) is the leading cause of death for men and women in Turkey as it is in Europe and US. The prevalence of the disease is 3.8% in Turkey and 200,000 patients are added to the pool of CHD annually. Because of genetic predisposition and high proportions of physical inactivity, smoking habit, and obesity, CHD is encountered in earlier ages in our country. So, the economic burden of the disease is expected to be relatively high, but the amount of health expenditure is not always parallel to the prevalence of a disease in the community. This article was written to overview CHD statistics to make a comparison between Turkey and some European countries and to investigate the value of myocardial perfusion scan (MPS) as a gatekeeper in diagnosing CHD before invasive coronary angiography (ICA). The consequences were evaluated for Turkey. In diagnosis; noninvasive testing gains importance in connection with the new approaches in treatment strategies, because a direct ICA strategy results in higher rates of revascularization without improvement in clinical outcomes. A “gatekeeper” is needed to select the patients who are not required to undergo angiography. MPS with its proved power in diagnosis and predicting prognosis, provides a cost-effective solution, and is accepted in some extensive analyses as a “gatekeeper” particularly in intermediate and high risk patients and in patients with known CHD. In conclusion, MPS may provide an optimal solution better than the ongoing situation in Turkey as well, when it is approved as a “gatekeeper in an algorithm before ICA. (MIRT 2011;20:75-93)

Anahtar Kelime:

Konular: Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	TAŞÇI C, ÖZÇELİK N (2011). An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. , 75 - 93.
Chicago	TAŞÇI Cengiz,ÖZÇELİK Nihat An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. (2011): 75 - 93.
MLA	TAŞÇI Cengiz,ÖZÇELİK Nihat An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. , 2011, ss.75 - 93.
AMA	TAŞÇI C,ÖZÇELİK N An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. . 2011; 75 - 93.
Vancouver	TAŞÇI C,ÖZÇELİK N An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. . 2011; 75 - 93.
IEEE	TAŞÇI C,ÖZÇELİK N "An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies." , ss.75 - 93, 2011.
ISNAD	TAŞÇI, Cengiz - ÖZÇELİK, Nihat. "An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies". (2011), 75-93.

APA	TAŞÇI C, ÖZÇELİK N (2011). An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. Molecular Imaging and Radionuclide Therapy, 20(3), 75 - 93.
Chicago	TAŞÇI Cengiz,ÖZÇELİK Nihat An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. Molecular Imaging and Radionuclide Therapy 20, no.3 (2011): 75 - 93.
MLA	TAŞÇI Cengiz,ÖZÇELİK Nihat An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. Molecular Imaging and Radionuclide Therapy, vol.20, no.3, 2011, ss.75 - 93.
AMA	TAŞÇI C,ÖZÇELİK N An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. Molecular Imaging and Radionuclide Therapy. 2011; 20(3): 75 - 93.
Vancouver	TAŞÇI C,ÖZÇELİK N An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies. Molecular Imaging and Radionuclide Therapy. 2011; 20(3): 75 - 93.
IEEE	TAŞÇI C,ÖZÇELİK N "An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies." Molecular Imaging and Radionuclide Therapy, 20, ss.75 - 93, 2011.
ISNAD	TAŞÇI, Cengiz - ÖZÇELİK, Nihat. "An Overview on coronary heart disease (A comparative evaluation of Turkey and Europe) and cost-effectiveness of diagnostic strategies". Molecular Imaging and Radionuclide Therapy 20/3 (2011), 75-93.