Coronary CT angiography leads to questionably appropriate interventions

Acute chest-pain patients imaged with coronary CT angiography (CCTA) are more likely to receive revascularization and invasive coronary interventions that don’t clearly improve outcomes than patients evaluated with standard functional tests such as stress EKG and stress echocardiography, according to a meta-analysis of randomized clinical trials.

On the other hand, CCTA was associated with decreased costs and hospital length of stay, “which has important implications, given the spiraling cost of medical care and the potential dangers of emergency-department crowding and increasing healthcare costs,” write Michael Gottlieb, MD, and Chase Socha, MD, both of Rush University in Chicago, in a synopsis of the meta-analysis.

The review, which covered 10 studies involving 6,285 patients, further found CCTA was not associated with a difference in all-cause mortality, major adverse cardiac events or myocardial infarction.

Still, angiography and revascularization “carry additional risks, which may not be accounted for in the current data,” Gottlieb and Socha write.

Their full synopsis is posted online in Annals of Emergency Medicine.