The Cost Effectiveness of Coronary CT Angiography and the Effective Utilization of CT-Fractional Flow Reserve in the Diagnosis of Coronary Artery Disease

Abstract

Given the high global disease burden of coronary artery disease (CAD), a major problem facing healthcare economic policy is identifying the most cost-effective diagnostic strategy for patients with suspected CAD. The aim of this review is to assess the long-term cost-effectiveness of coronary computed tomography angiography (CCTA) when compared with other diagnostic modalities and to define the cost and effective diagnostic utilization of computed tomography-fractional flow reserve (CT-FFR). A search was conducted through the MEDLINE database using PubMed with 16 of 119 manuscripts fitting the inclusion and exclusion criteria for review. An analysis of the data included in this review suggests that CCTA is a cost-effective strategy for both low risk acute chest pain patients presenting to the emergency department (ED) and low-to-intermediate risk stable chest pain outpatients. For patients with intermediate-to-high risk, CT-FFR is superior to CCTA in identifying clinically significant stenosis. In low-to-intermediate risk patients, CCTA provides a cost-effective diagnostic strategy with the potential to reduce economic burden and improve long-term health outcomes. CT-FFR should be utilized in intermediate-to-high risk patients with stenosis of uncertain clinical significance. Long-term analysis of cost-effectiveness and diagnostic utility is needed to determine the optimal balance between the cost-effectiveness and diagnostic utility of CT-FFR.

Polyurethane Nanoparticles as Versatile Tools in Nanomedicine: A Review

“…99,100 The diagnosis and treatment of critical illnesses were significantly impacted between 2019 and 2023 by the use of MRI, PET, computed tomography (CT), angiography scans, other techniques, and combinations of them. 101 The surgical strategy has been improved with the use of CT, MRI, and ultrasound images. Polyurethane nanoparticles labeled with small molecular Table 4.…”

“…In recent years, multidisciplinary research has increasingly relied on the advancement of nanotechnologies for the identification of various diseases. By precisely targeting affected locations inside the body with nanomedicines, the toxicity and dosage of medications and diagnostics can be significantly lowered. , The diagnosis and treatment of critical illnesses were significantly impacted between 2019 and 2023 by the use of MRI, PET, computed tomography (CT), angiography scans, other techniques, and combinations of them . The surgical strategy has been improved with the use of CT, MRI, and ultrasound images.…”

Non-Contrast and Contrast-Enhanced Cardiac Computed Tomography Imaging in the Diagnostic and Prognostic Evaluation of Coronary Artery Disease

“…A meta-analysis including most of the above studies in patients with either acute or stable chest pain showed that anatomical testing with CCTA as the initial non-invasive diagnostic modality resulted in a lower risk of non-fatal myocardial infarction, but not MACEs or all-cause mortality, as compared with the usual care with functional testing at the expense of a more frequent use of invasive procedures [ 102 ]. Moreover, a systematic review in patients with acute or stable chest pain showed that CCTA is cost-effective when compared with the standard of care, including functional testing [ 103 ].…”