Effects on costs of frontline diagnostic evaluation in patients suspected of angina: Coronary computed tomography angiography vs. conventional ischaemia testing

European Heart Journal Cardiovascular Imaging

Volumn 14, Issue 5, 2013, Pages 449-455

  Nielsen, Lene H ^a   Olsen, Jens ^b   Markenvard, John ^a   Jensen, Jesper M ^a   Nørgaard, Bjarne L ^c  

^a LILLEBAELT HOSPITAL   (Denmark)

^b UNIVERSITY OF SOUTHERN DENMARK   (Denmark)

^c AARHUS UNIVERSITY HOSPITAL   (Denmark)

Author keywords

Coronary computed tomography angiography; Cost analysis; Exercise stress testing; Non invasive ischaemia testing

Indexed keywords

ADULT; AGE; AMBULATORY CARE; ARTICLE; ASYMPTOMATIC DISEASE; COMPUTED TOMOGRAPHIC ANGIOGRAPHY; CONTROLLED STUDY; CONVENTIONAL ANGIOGRAPHY; CORONARY ARTERY DISEASE; DEMOGRAPHY; DENMARK; DISEASE ASSOCIATION; EXERCISE TEST; FEMALE; FOLLOW UP; GENDER; HEALTH CARE COST; HEART DEATH; HEART INFARCTION; HOSPITALIZATION; HUMAN; INTERMETHOD COMPARISON; MAJOR CLINICAL STUDY; MALE; PRIORITY JOURNAL; PROBABILITY; RETROSPECTIVE STUDY; STABLE ANGINA PECTORIS;

ADULT; AGED; ANGINA PECTORIS; COHORT STUDIES; CORONARY ANGIOGRAPHY; COST-BENEFIT ANALYSIS; EXERCISE TEST; FEMALE; FOLLOW-UP STUDIES; HUMANS; MALE; MIDDLE AGED; MONITORING, PHYSIOLOGIC; PROSPECTIVE STUDIES; TIME FACTORS; TOMOGRAPHY, X-RAY COMPUTED;

EID: 84876572732     PISSN: 20472404     EISSN: None     Source Type: Journal    
DOI: 10.1093/ehjci/jes166     Document Type: Article

References (25)

1. Allender S, Scarborough P, Peto V, Raynar M. British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford. European Cardiovascular Disease Statistics; 2008. p12-31 (chapter 1
2. Leal J, Luengo-Fernandez R, Gray A. Health Economic Research Group, Department of Public Health, University of Oxford. European Cardiovascular Disease Statistics; 2008. p214-9 (chapter 12
3. Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F et al.; Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology; ESC Committee for Practice Guidelines (CPG). Guidelines on the management of stable angina pectoris: Executive summary: The task force on the management of stable angina pectoris of the European Society of Cardiology. Eur Heart J 2006;27:1341-81
4. Schroeder S, Achenbach S, Bengel F, Burgstahler C, Cademartiri F, de Feyter P et al. Cardiac computed tomography: Indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. Eur Heart J 2008;29: 531-56
5. Redberg RF, Walsh J. Pay now, benefits may follow -The case of cardiac computed tomographic angiography. N Engl J Med 2008;359:2309-10
6. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary artery disease. N Engl J Med 1979;300:1350-8
7. Diamond GA. A clinically relevant classification of chest discomfort. J Am Coll Cardiol 1983;1(2 Pt 1):574-5
8. Saunamäki K, Egstrup K, Krusell L, Mickley H, Nielsen JR, Schnohr P. Working Group under The Danish Society of Cardiology. Indicative guidelines for clinical exercise test in relation to ischemic heart disease 2001. www.cadio.dk.
9. Ovrehus KA, Jensen JK, Mickley HF, Munkholm H, Bøttcher M, Bøtker HE et al. Comparison of usefulness of exercise testing versus coronary computed tomographic angiography for evaluation of patients suspected of having coronary artery disease. Am J Cardiol 2010;105:773-9
10. Bongartz G, Golding SJ, Jurik AG, Leonardi M, van Persijn van Meerten E, Rodriquez R et al. European guidelines for multislice computed tomography: 2004 CT quality criteria. Appendix C www.msct.eu/PDF-FILES/EC%20CA% 20Report%20D5%20-%20Dosimetry.pdf
11. Glick HA, Doshi JA, Sonnad SS, Polsky D. Analyzing Cost. Economic Evaluation in Clinical Trials. Oxford (UK): Oxford University Press, 2007
12. Nielsen LH, Markenvard J, Jensen JM, Mickley H, Ovrehus KA, Nørgaard BL. Frontline diagnostic evaluation of patients suspected of angina by coronary computed tomography reduces downstream resource utilization when compared to conventional ischemia testing. Int J Cardiovasc Imag 2011;27:813-23
13. Shaw LJ, Marwick TH, Berman DS, Sawada S, Heller GV, Vasey C et al. Incremental cost-effectiveness of exercise echocardiography vs. SPECT imaging for the evaluation of stable chest pain. Eur Heart J 2006;27:2448-58
14. Machaalany J, Yam Y, Ruddy TD, Abraham A, Chen L, Beanlands RS et al. Potential clinical and economic consequences of noncardiac incidential findings on cardiac computed tomography. J Am Coll Cardiol 2009;54:1533-1
15. Dewey M, Hamm B. Cost effectiveness of coronary angiography and calcium scoring using CT and stress MRI for diagnosis of coronary artery disease. Eur Radiol 2007;17:1301-9
16. Min JK, Kang N, Shaw LJ, Devereux RB, Robinson M, Lin F et al. Costs and clinical outcomes after coronary multidetector CT angiography in patients without known coronary artery disease: Comparison to myocardial perfusion SPECT. Radiology 2008;249:62-70
17. Shreibati JB, Baker LC, Hlatky MA. Association of coronary CT angiography or stress testing with subsequent utilization and spending among medicare beneficiaries. JAMA 2011;306:2128-36
18. Ovrehus KA, Munkholm H, Bøttcher M, Bøtker HE, Nørgaard BL. Coronary computed tomographic angiography in patients suspected of coronary artery disease: Impact of observer experience on diagnostic performance and interobserver reproducibility. J Cardiovasc Comput Tomogr 2010;4:186-94
19. Dedic A, Genders TS, Ferket BS, Galema TW, Mollet NR, Moelker A et al. Stable angina pectoris: Head-To-head comparison of prognostic value of cardiac CT and exercise testing. Radiology. 2011;261:428-36
20. Cheng V, Gutstein A, Wolak A, Suzuki Y, Dey D, Gransar H et al. Moving beyond binary grading of coronary arterial stenoses on coronary computed tomographic angiography: Insights for the imager and referring clinician. J Am Coll Cardiol Imag 2008;1:460-71
21. Fearon WF, Bornschein B, Tonino PA, Gothe RM, Bruyne BD, Pijls NH et al. Economic evaluation of fractional flow reserve-guided percutaneous coronary intervention in patients with multivessel disease. Circulation 2010;122:2545-50
22. Einstein AJ, Moser KW, Thompson RC, Cerqueira MD, Henzlova MJ. Radiation dose to patients from cardiac diagnostic imaging. Circulation 2007;116:1290-305
23. Pflederer T, Jakstat J, Marwan M, Schepis T, Bachmann S, Kuettner A et al. Radiation exposure and image quality in staged lowdose protocols for coronary dualsource CT angiography: A randomized comparison. Eur Radiol 2010;20:1197-206
24. Achenbach S, Marwan M, Ropers D, Schepis T, Pflederer T, Anders K et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-Triggered high pitch spiral acquisition. Eur Heart J 2010;31:340-6
25. Douglas PS, Taylor A, Bild D, Bonow R, Greenland P, Lauer M et al. Outcomes research in cardiovascular imaging: Report of a workshop sponsored by the National Heart, Lung, and Blood Institute. JACC Cardiovasc Imag 2009;2:897-907