title: Clinical management and short-term cost - 64-slice MDCT vs. myocardial perfusion scintigraphy.
abstract: There are currently no published studies of the impact of CT coronary angiography (CTA) on patient management or cost when compared with other established imaging techniques. We assessed the short term investigation and treatment costs of CTA compared with myocardial perfusion scintigraphy (MPS) using real clinical scenarios. Clinical information with either their CTA or MPS results were presented to 20 cardiologists in a random order. They decided further investigations and treatment required based on these data. Short term cost was calculated for each imaging strategy. Whilst the total number of further investigations requested did not differ between groups patients undergoing CTA were more likely to be referred for invasive coronary angiography, receive aspirin, statins, ACE inhibitors, β-blockers or clopidogrel. Overall cost and investigation costs were similar between CTA and MPS; however treatment costs were higher with CTA. There are significant differences in further clinical management when using CTA compared with MPS, in particular with greater use of secondary preventative medication.
authors.forename: Edward D
authors.initials: ED
authors.lastname: Nicol
authors.forename: James
authors.initials: J
authors.lastname: Stirrup
authors.forename: Edward
authors.initials: E
authors.lastname: Leatham
authors.forename: Michael
authors.initials: M
authors.lastname: Roughton
authors.forename: S Richard
authors.initials: SR
authors.lastname: Underwood
authors.forename: Simon P G
authors.initials: SP
authors.lastname: Padley
authors.forename: Michael B
authors.initials: MB
authors.lastname: Rubens
mesh_terms: D017023:Coronary Angiography / Q000191:economics* / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003365:Costs and Cost Analysis; D006801:Humans; D055414:Myocardial Perfusion Imaging / Q000191:economics*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000191:economics*