CTA Offers Screening Benefits for Low Risk Angina Patients
A study from the Walter Reed Medical Center validates the utility of coronary CT angiography (CCTA) for those patients seen in the outpatient setting who may have angina and are low- to intermediate- risk. Additional studies are required to further assess the cost-effectiveness of the approach.
The research team at the Defense facility completed a trial to examine the utility of CCTA and pre-CCTA. The team identified 75 patients prospectively who underwent CTA for angina assessment. The findings from the investigation were published in the Journal of Cardiovascular Computed Tomography.
The findings from CTA were reviewed by two cardiologists, who determined the likelihood of coronary artery disease based on the imaging and other relevant data. They then chose the next appropriate steps; including stress testing with imaging, traditional coronary angiography, graded exercise mill test, and no other assessment.
Based on the findings, the team determined that assessing patients with CCTA reduces the downstream utilization of both cardiac stress testing and cardiac catheterization. It also diminishes the unnecessary use of cardiac catheterization. It appears, based on this data, that CCTA can both rule out or confirm coronary disease and is superior to SPECT.
The research was completed in light of the frequency of cardiac testing utilization. Review of data indicates that coronary angiography and stress testing may be used more than necessary. Costs to evaluate patients for such are ten percent of the total costs for cardiovascular disease.
A number of studies are ongoing to assess the cost-effectiveness of CT, as well as patient outcomes in this same patient population.
August 19, 2008 Related topics: Imaging, Diagnostic, Cardiology