In what the American College of Radiology Imaging Network (ACRIN) is calling a landmark study that will save lives, time, and money, coronary CT angiography (CCTA) was found to be more effective in treating ER patients with chest pain than traditional methods.
The multicenter study examined the effects of CCTA on 908 low-to-intermediate-risk chest pain patients. Of the 640 participants whose CCTAs were negative, zero suffered a heart attack or died within 30 days after being discharged on the strength of their test results, ACRIN reports.
Pamela K. Woodard, MD, head of advanced cardiac imaging at the Washington University School of Medicine and chair of the ACRIN Cardiovascular Committee, says CCTA is a superior treatment because it provides a clear picture of the problem for patients presenting with chest pain.
“CCTA not only has a high negative predictive value, but for low-to-intermediate-risk patients, it is a very fast, safe, effective mechanism for diagnosis,” Woodard says.
“You’re getting direct visualization of the atherosclerosis. If someone has absolutely clean coronaries, you don’t have disease,” she says.
Woodard says CCTA is an especially viable treatment procedure because of the availability in many hospitals of 64-slice (minimum) CT scanners and the relative ease of conducting the scan.
“The study itself is fairly quick,” she says, “anywhere from 10-15 seconds. Most of your time is getting the scout imaging and the EKG leads. Getting into the room, it’s probably no more than 15 minutes.”
The ACRIN trial “found that low- to intermediate-risk patients who underwent a CCTA were more than twice as likely to be discharged and had significantly shorter hospital stays than those who received traditional care,” ACR reported in a statement.
Woodard says results like those will influence not only patient discharge rates, as fewer patients will be hospitalized for precautionary reasons, but they will also improve hospital bottom lines.
“It’s going to be more cost-effective because patients are going to be getting out of the ER faster,” she says. “[CCTA can determine whether] the vast majority of these patients need to be admitted or they can go home.”
Although Woodard expects that hospitals “will start using CCTA as a principal means of assessment,” she cautions not to expect things to change overnight.
“Habits change slowly,” Woodard said. “This is going to be a landmark, multi-center trial that demonstrates that coronary CTA is safe and [will] result in [the] quick discharge from the ER of low-to-intermediate-risk patients,” she said.