A new Thomas Jefferson University study published in the May issue of the American Journal of Roentgenology (AJR) shows evidence that coronary CTA is a cost-effective alternative to cardiac catheterization for certain coronary artery disease (CAD) patients.

The study, “Cost-Effectiveness of Coronary CT Angiography in Evaluation of Patients Without Symptoms Who Have Positive Stress Test Results” by researchers Halpern, Savage, Fischman, et al pertains to patients who have positive stress test results, but who also have a less than a 50 % chance of actually having significant CAD.

Typically, patients with positive CAD stress test results but no heart-related symptoms, or who have atypical chest pain, receive referrals for cardiac catheterization testing to evaluate CAD.

To evaluate the cost effectiveness of coronary CTA versus cardiac catheterization for these patients, the researchers compared the false-negative rates, false-positive rates, costs, and radiation exposure of direct referral of patients to cardiac catheterization with the values associated with performing coronary CTA before catheterization.

Lead author, Ethan J. Halpern, MD, explained in an AJR press release “At a 50% prevalence of CAD, we found that performing coronary CTA before cardiac catheterization results in an average cost saving of $789 per patient with a false-negative rate of 2.5 percent and average additional radiation exposure of 1-2 mSv, which is minimal,” said Halpern.  

Halpern added, “According to our results, when a patient with an expected CAD prevalence of less than 85% is found to have a positive stress test result, coronary CTA is a less expensive alternative to direct performance of cardiac catheterization.”

The researchers’ conclusion is that if the pretest probability of CAD is low, then coronary CTA findings are more likely to avoid the costs of cardiac catheterization, as well as reduce the patient’s radiation dose.

Read the full article in the AJR’s May issue or online.


(Source: AJR press release.)