CT angiography can cut the time and costs needed to evaluate acute chest pain and quickly diagnose and treat heart attacks, according to a study this week presented at the annual meeting of the American College of Cardiology in Atlanta titled “Immediate Coronary Artery Computed Tomographic Angiography Rapidly and Definitively Excludes Coronary Artery Disease in Low-Risk Acute Chest Pain (Abstract 807-8).”
Researchers from the William Beaumont Hospital in Michigan evaluated the use of CT angiography (CTA) with 3D to exclude coronary artery disease (CAD) as the cause of acute chest pain. The team found that CTA alone quickly and accurately ruled out significant CAD in 89 percent of cases, and CAD was correctly assessed in 100 percent of the CTA patients.
Study authors randomized 200 patients with low-risk acute chest pain to either an immediate 64-slice CTA or a standard of care evaluation, which includes an electrocardiogram (EKG), serial cardiac enzymes and rest-stress nuclear scanning. CTA quickly ruled out CAD in most cases, with reducing the total time patients spent in the emergency room by 45 percent. In addition to saving time, CTA was approximately $300 less expensive per patient than standard of care procedures. In the study, both the CTA group and the standard of care group had similar demographics, risk factors and thrombolysis in myocardial infarction risk scores, a test used to determine a patient’s risk of mortality, the authors said.
"Our study shows that CTA can rapidly and definitively exclude CAD as the cause for acute chest pain," said Gilbert L. Raff, MD, of William Beaumont Hospital and lead author of the study. "Immediate use of CTA helps reduce a patient’s length of hospital stay and decreases overall cost without putting the patient at increased risk."