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: New research demonstrates benefits of national and international device registries

add to favorites email to friend print save as pdf

Related Stories

Your info has been hacked. Now what do you do?

7 minutes ago

Criminals stole personal information from tens of millions of Americans in data breaches this past year. Of those affected, one in three may become victims of identity theft, according to research firm Javelin. ...

New Bond script stolen in Sony hack

10 minutes ago

An "early version" of the screenplay for the new James Bond film was the latest victim of a massive hacking attack on Sony Pictures Entertainment, its producers said in a statement on their website Sunday.

Ag-tech could change how the world eats

5 hours ago

Investors and entrepreneurs behind some of the world's newest industries have started to put their money and tech talents into farming - the world's oldest industry - with an audacious agenda: to make sure there is enough ...

World's rarest cetacean threatened by illegal gillnets

6 hours ago

The world's rarest cetacean could disappear in less than four years unless immediate action is taken by the Mexican government to protect it from entanglement in gillnets deployed illegally in its Gulf of California refuge, ...

Recommended for you

New approach to particle therapy dosimetry

1 hour ago

Researchers at the National Physical Laboratory (NPL), in collaboration with EMRP partners, are working towards a universal approach to particle beam therapy dosimetry.

Supplement maker admits lying about ingredients

Dec 17, 2014

Federal prosecutors say the owner and president of a dietary supplement company has admitted his role in the sale of diluted and adulterated dietary ingredients and supplements sold by his company.

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.