News | February 05, 2013

Prospective Study Indicates Efficiency of Coronary CT Angiography in the Emergency Department

Coupled with simple chest pain protocol, it can be used to quickly triage in low to intermediate risk patients with chest pain in the emergency department

 

February 5, 2013 — A prospective clinical study was published recently in the American Journal of Roentgenology on whether coronary computed tomography angiography (CTA) provided an accurate and efficient management method for assessment of chest pain patients with low to intermediate risk of acute coronary syndrome (ACS). This study, presented by Ricardo C. Cury, M.D., of Baptist Health of South Florida, current vice president of the Society of Cardiovascular Computed Tomography (SCCT) and colleagues, was carried out over three emergency departments in a large healthcare system, between January 2009 and October 2010, and found that length of stay was cut in half, and the rate of major adverse cardiac events (MACE) remained very low in patients with negative CTA findings.

More than six million visits to emergency departments occur annually in the United States, made by patients experiencing chest pain. These visits can lead to a series of downstream testing, consuming both time and expense. 529 patients experiencing chest pain were admitted to the emergency departments and were treated with CTA. A dedicated chest pain triage protocol was implemented in five levels. After undergoing CTA treatment, the patients were grouped by level of severity in risk group, including no disease, mild, moderate and severe risk.

Outcome measures of the study included MACE rate during the first thirty days after CTA, length of stay, radiation dose, diagnosis time and downstream testing results. The length of stay was compared both pre- and post-implementation of the triaging system and found a 51 percent decrease in length of stay, lowered from 28.8 to 14.0 hours.

88.5 percent of patients were classified as having no disease or mild non-obstructive disease by CTA and were discharged from the emergency department after CTA. The downstream testing rate in this group was 3.2 percent, with very low MACE occurring in thirty days (0.2 percent). In comparison patients with stenosis of 70 percent or greater had 8.3 percent of MACE. With the fast patient release and the low downstream testing rate, CTA provides a potential cost-savings in the emergency department.

"This study adds to the body of literature supporting the use of coronary CTA in the emergency department setting," says Cury. "It reinforces the notion that CTA can be successfully implemented in the ER setting if coupled with a dedicated chest pain pathway guiding clinicians on when to order the test appropriate and how to act on the test results."

John Lesser, current president of SCCT, adds: "This prospective study by Cury et al. strongly reinforces the results from three previous randomized trials of coronary CTA in the ED. Most importantly, they were successful limiting downstream testing and costs by using a defined protocol that detailed how to act on the test results."

For more information: www.SCCT.org

Related Content

Coreline Soft Introduces AI Lung Segmentation Solution at RSNA 2018
News | Lung Cancer | December 10, 2018
December 10, 2018 — Korean image software company Coreline Soft Co. Ltd.
FDA Approves New Features for Planmed Verity Cone Beam CT Scanner
Technology | Computed Tomography (CT) | December 07, 2018
The U.S. Food and Drug Administration (FDA) issued an approval letter for the new features and intended uses of the...
YITU Releases AI-Based Cancer Screening Solutions at RSNA 2018
News | Artificial Intelligence | December 06, 2018
Chinese artificial intelligence (AI) healthcare company YITU healthcare released two brand-new products, Intelligent...
Guerbet Launches Multi-Use OptiVantage Contrast Media Injector in Europe
Technology | Contrast Media Injectors | December 05, 2018
Contrast agent company Guerbet recently announced that the OptiVantage multi-use contrast media injector is now CE...
GE Healthcare Unveils New Applications and Smart Devices Built on Edison Platform
Technology | Artificial Intelligence | December 05, 2018
GE Healthcare recently announced new applications and smart devices built on Edison – a platform that helps accelerate...
ScreenPoint Medical and Volpara Partner to Bring AI to Breast Imaging Clinics
News | Computer-Aided Detection Software | December 04, 2018
ScreenPoint Medical has signed a memorandum of understanding (MOU) with Volpara Health Technologies. Volpara will...
Infervision Introduces AI Capabilities for Chest CT Reading
Technology | Computer-Aided Detection Software | November 30, 2018
Big data and artificial intelligence (AI) company Infervision announced the launch of InferRead CT Chest, a new product...
NeuroLogica and MaxQ AI Announce Distribution Agreement
News | Stroke | November 30, 2018
Clinical diagnostics intelligence platform company MaxQ AI and Samsung NeuroLogica announced a distribution agreement...
Videos | Advanced Visualization | November 30, 2018
This is an example of the FDA-cleared OpenSight augmented reality (AR) system for surgical planning from NovaRad at t