VIENNA – Coronary CT followed by some form of functional stress imaging when needed now stands as the most cost-effective way to screen patients with chest pain regardless of whether the pain is chronic or acute onset.
Results from a 2011 analysis established the cost efficacy of cardiac CT followed by stress imaging for patients with positive CT results for acute chest-pain patients at low or intermediate risk for coronary disease, and no data reported since then have changed that conclusion, Dr. Thomas H. Marwick said at the annual meeting of the European Association of Cardiovascular Imaging.
Results from a new analysis presented in a separate report at the meeting showed the superior cost effectiveness of the same approach for patients with stable chest pain who are at low or intermediate risk for having coronary disease, said Dr. Steffen E. Petersen, professor and head of the Centre for Advanced Cardiovascular Imaging at the William Harvey Research Institute in London.
“We did a cost-effectiveness analysis that took into account the cost of results that lead to additional testing and the cost when people return later with symptoms and need more testing. We compared about 15 different strategies, and found it was best to start with CT and if that was positive then do a functional test like stress echocardiography, stress single-photon emission CT (SPECT), or stress MRI. CT followed by stress echo seemed most cost effective, but using stress SPECT or MRI was not very different; they can all be used after CT,” Dr. Petersen said in an interview.
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