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  • July 2007

    Cost-Effectiveness in CT Angiography

    Journal of Cardiovascular Computed Tomography | Jason H. Cole et al.

    Article:

    Cost Implications of Initial Computed Tomography Angiography as Opposed to Catheterization in Patients with Mildly Abnormal or Equivocal Myocardial Perfusion Scans

    Authors:

    Jason H. Cole, MD, MS; Vance M. Chunn, MSHHA; J. Andrew Morrow, MD; Ralph S. Buckley, MD; Gerry M. Phillips, MD

    Journal:

    Journal of Cardiovascular Computed Tomography, 2007

    Summary:

    The purpose of this study was to analyze the cost implications of CCTA before catheterization in patients with mildly abnormal or equivocal MPI scans. 206 Patients with mildly abnormal or equivocal MPI scans underwent 64-detector CCTA instead of catheterization at the discretion of a treating physician. Studies were evaluated by a trained reader, and results were classified as “no evident CAD,” “nonobstructive CAD,” or “potentially obstructive CAD.” Cost data were analyzed based on actual reimbursements for CT angiography and cardiac catheterization.

    Thirty-two percent of patients had potentially obstructive plaque on CTA. Selective catheterization saves $1454 per patient. Sensitivity analysis revealed cost savings to be preserved even if up to 81.5% of the patient cohort undergoes catheterization, as well as across wide ranges of procedural costs.

    Researchers concluded that, “A strategy that uses CCTA as a gatekeeper to catheterization is cost saving as opposed to initial catheterization for patients with equivocal or mildly abnormal myocardial perfusion.”

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