Imaging deemed more effective than exercise tolerance testing
(HealthDay)—For patients presenting with suspected coronary artery disease (CAD), cardiac imaging leads to fewer invasive coronary angiography (ICA) procedures and a higher yield of CAD, and is associated with lower costs than a traditional exercise tolerance test (ETT) strategy, according to a study published in the June 15 issue of The American Journal of Cardiology.
Ozan M. Demir, M.B.B.S., from University Hospital Lewisham in London, and colleagues collected data for patients seen in rapid access chest pain clinics in two hospitals over a 12-month period. Hospitals A and B investigated patients by performing ETT and cardiac imaging, respectively. Overall, 483 patients were included from hospital A, of whom 43.3 percent (209 patients) had contraindications for ETT, while 295 patients were included from hospital B.
The researchers found that 26.3 percent of the population for hospital A underwent ICA (127 procedures) and 40.9 percent had obstructive CAD. In hospital B, 21.4 percent of the population underwent ICA (63 procedures) and 50.8 percent had obstructive CAD. The average cost per patient was $875 ± 758 and $750 ± 725 in hospitals A and B, respectively (P < 0.001).
"In conclusion, our results suggest that a cardiac imaging pathway leads to fewer ICA and a higher yield of obstructive CAD at lower cost per patient," the authors write.
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