By Deborah Brauser
ORLANDO, Fla -- November 23, 2009 -- Coronary computed tomographic angiography (CCTA) has a decreased diagnosis time and lower cost of care than standard emergency department (ED) triage, according to a multicentre study presented here at the American Heart Association (AHA) Scientific Sessions 2009.
James A. Goldstein, MD, William Beaumont Hospital, Royal Oak, Michigan, presented results from the Coronary Computed Tomography for Systematic Triage of Acute Chest Pain Patients to Treatment (CT-STAT) study here on November 18.
A total of 749 low- to intermediate-risk patients with acute chest pain in the previous 12 hours were enrolled at 16 EDs across the United States and randomly assigned to receive either CCTA (n = 376) or standard screening with myocardial perfusion imaging (MPI; n = 373).
Outcomes included safety, defined as "freedom from 6-month major adverse cardiac events," and efficiency or "time to disposition and emergency department cost of care," according to Dr. Goldstein.
Results showed 100% safety for both groups with no deaths reported at follow-up. The number of patients who underwent invasive angiography during the index visit was also similar for the CCTA and MPI groups (5.1% vs 4.6%, respectively).
However, the median diagnosis time was significantly lower for the patients receiving CCTA compared with those receiving MPI (2.9 vs 6.3 hours, respectively; P < .0001).
In addition, the cost of care was also significantly lower for the CCTA patients compared with MPI patients (P < .0001).
"While both methods were entirely safe and similar numbers of patients underwent invasive angiography during their first visit, the diagnosis times for CCTA patients was about 54% less and cost of care for this group was about 38% lower," said Dr. Goldstein.
"We'll also be following up with these patients to look at long-term impact with both inpatient and outpatient testing," said Dr. Goldstein. "This will be to look not only at heart events but also at resource utilisations down stream."
[Presentation title: Coronary Computed Tomography for Systematic Triage of Acute Chest Pain Patients to Treatment - (The CT-STAT Trial). Abstract LBCT-20017]
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