Multidetector CT coronary angiography for patient triage to invasive coronary angiography: Performance and cost in ambulatory patients with equivocal or suspected inaccurate noninvasive stress tests

Abstract

MDCTA shows excellent performance as a triage for invasive angiography in patients with stress tests that are equivocal or thought inaccurate. A negative CTA confers good 12-month prognosis. Substantial cost savings may accrue using MDCTA in this triage role.

Prognostic Value of Cardiac Computed Tomography Angiography

“…The abstract or full text of the 39 remaining studies were evaluated to determine eligibility. Twenty-one studies (14,15,23,25,28,(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56) were excluded after further review for reasons outlined in Figure 1. Eighteen studies were identified for inclusion from the literature search (7,8,10 -12,16 -22,24,26 -30).…”

Prognostic Value of CT Angiography in Patients With Inconclusive Functional Stress Tests

“…As previously mentioned, the application of current investigation algorithms in "real-world" clinical practice results in a large number of ICAs that do not demonstrate any significant coronary obstruction and, thus, do not lead to any therapeutic intervention (1). The results of 2 recent studies suggest that the strategy of using coronary CTA as a gatekeeper to ICA could be cost saving in patients with equivocal noninvasive stress tests (17,18). Accordingly, the ACCF/SCCT/ACR/AHA/ASE/ ASNC/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography (12) defined the use of coronary CTA in patients with equivocal or discordant stress tests as an appropriate indication.…”

Coronary Computed Tomography Angiography in Patients With Chronic Chest Pain

“…1 The few available studies suggest that this may be a cost-effective strategy, with up to a 4-fold reduction in costs driven by reductions in unnecessary invasive coronary angiography 77,78 ; however, these are limited to small, single-center observational studies. 1 The few available studies suggest that this may be a cost-effective strategy, with up to a 4-fold reduction in costs driven by reductions in unnecessary invasive coronary angiography 77,78 ; however, these are limited to small, single-center observational studies.…”