Resource implications following expansion of computed tomography coronary angiography: An Australian experience.

Publisher: Wiley-Blackwell Pub. Asia Country of Publication: Australia NLM ID: 101469340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1754-9485 (Electronic) Linking ISSN: 17549477 NLM ISO Abbreviation: J Med Imaging Radiat Oncol Subsets: MEDLINE

Publication: Carlton, Vic. : Wiley-Blackwell Pub. Asia
Original Publication: Carlton, Vic. : Blackwell Pub. Asia, c2008-

Coronary Artery Disease*/diagnostic imaging; Computed Tomography Angiography/methods ; Coronary Angiography/methods ; Female ; Humans ; Male ; Predictive Value of Tests ; Retrospective Studies ; Victoria

Introduction: To determine the downstream utilisation of Computed Tomography Coronary Angiography (CTCA) in a single Australian tertiary centre.
Methods: A single-centre retrospective study analysed 1460 patients undergoing CTCA between 1st January 2015 to 31st December 2018 at a tertiary hospital in Victoria, Australia, with a catchment area of 500,000 people. The coronary stenosis grading, plaque characteristics and coronary calcium score were identified. The downstream impact was assessed by measuring the number of stress echocardiograms, myocardial perfusion scans (MPS), invasive coronary angiograms and subsequent revascularisations.
Results: The number of CTCA's performed steadily increased from 59 in 2015 to 395, 461 and 545 in 2016, 2017 and 2018 respectively. Seven hundred and fifty-seven (52%) were females, and 703 (48%) males with 724 (50%) normal CTCA studies. The number of downstream stress echocardiogram performed each year was 2, 60, 46 and 16, respectively, accompanied by MPS numbers of 0, 21, 29, and 18. There were 9, 37, 57 and 64 invasive coronary angiograms with 1, 13, 19 and 22 corresponding revascularisations. Despite small increases in absolute numbers of patients presenting with chest pain (from 2678 in 2015 to 3660 in 2018), there was a significant increase in downstream further testing from 11 in 2015 to 98 in 2018.
Conclusion: The use of CTCA expansion has resulted in an increase in downstream testing. Therefore, resource planning with regards to CTCA expansion will have to account for increased rates of functional testing, invasive angiography and revascularisation.
(© 2021 The Royal Australian and New Zealand College of Radiologists.)

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Keywords: cardiac imaging; cardiology

Date Created: 20210920 Date Completed: 20220805 Latest Revision: 20220805

20231215

10.1111/1754-9485.13331

34541762