Coronary CTA costs less than standard of care for triaging women with acute chest pain

Aug 08, 2008

Non-invasive coronary CT angiography (CTA) is more cost-effective than current tests for diagnosing women with low risk of a heart attack who come to the emergency room with acute chest pain, according to a recent study conducted by researchers at Harvard University in Cambridge, MA.

The researchers developed a microsimulation coronary CTA model which reviewed costs and health effects of performing coronary CT angiography and either discharging, stress testing, or referring emergency department patients for invasive coronary angiography, depending on their severity of atherosclerosis, compared with a standard-of-care (SOC) algorithm that based management on biomarkers and stress tests alone. "The SOC is to get a few sets of cardiac enzymes on these patients and to perform a stress test. If either is positive, the patient may be considered for cardiac catheterization," said Joseph Ladapo, MD, PhD lead author of the study.

Coronary CT angiography was $410 less (in emergency department and hospital costs) than the SOC to triage a 55-year-old woman, said Dr. Ladapo. Total health care costs decreased by $380, he said. "At nearly every age level, women are less likely to have coronary artery disease than men; they are more likely to be found to have normal coronaries on cardiac CT, and therefore more likely to be discharged. Since they are discharged, costs go down," Dr. Ladapo said.

55-year-old men with acute chest pain increased emergency department and hospital costs by $110 and raised total health care costs by $200, Dr. Ladapo said. Coronary CT angiography raised overall costs in men primarily because it was more likely to identify patients with coronary artery disease, Dr. Ladapo said. The patients needed additional testing or treatment, so costs went up.

"Coronary CT angiography with high-resolution CT scanners is an exciting innovation whose implications for health outcomes and medical care costs are poorly understood," said Dr. Ladapo. "I think our study brings us closer to understanding how patient care might be affected by its application and reinforcing the role of this technology in patient care," said Dr. Ladapo.

"I think the day may come when this technology is regularly used to triage patients that would otherwise end up waiting for hours in the emergency department for a stress test and another set of cardiac enzymes. As physicians design protocols that further reduce the radiation dose associated with exams, and as engineers design faster multislice CTs, the radiation dose (the main major risk of the procedure) will fall," said Dr. Ladapo. "Indeed, it has already fallen significantly for these reasons," he said. "Coronary CT angiography is more efficient than a stress test in the identification of coronary artery disease," he added.

Source: American Roentgen Ray Society

Explore further: Allergan to cut 1,500 employees in restructuring (Update)

add to favorites email to friend print save as pdf

Related Stories

Google made failed bid for Spotify

43 minutes ago

Internet titan Google tried last year to buy streaming music service Spotify but backed off for reasons including a whopping price tag, the Wall Street Journal reported on Tuesday.

Thieves got into 1K StubHub accounts

1 hour ago

(AP)—Cyber thieves got into more than 1,000 StubHub customers' accounts and fraudulently bought tickets for events through the online ticket reseller, a law enforcement official and the company said Tuesday.

Microsoft CEO sees 'bold' plan as 4Q tops Street

1 hour ago

(AP)—Microsoft Corp. CEO Satya Nadella painted an upbeat vision of the future Tuesday, saying that the next version of Windows will be unified across screens of all sizes and that two money-losing units—Nokia ...

Recommended for you

British Lords hold ten-hour debate on assisted dying

Jul 19, 2014

Members of Britain's unelected House of Lords spent almost ten hours on Friday discussing whether to legalise assisted dying, in an often emotional debate putting the question back on the agenda, if not on the statute books.

AbbVie, Shire agree on $55B combination

Jul 18, 2014

The drugmaker AbbVie has reached a deal worth roughly $55 billion to combine with British counterpart Shire and become the latest U.S. company to seek an overseas haven from tax rates back home.

Safety problems at US germ labs acknowledged

Jul 16, 2014

(AP)—The director of the U.S. Centers for Disease Control and Prevention acknowledged Wednesday that systemic safety problems have for years plagued federal public health laboratories that handle dangerous ...

User comments : 0