International Journal of Cardiovascular ResearchISSN: 2324-8602

Reach Us +1 850 900 2634

Research Article, Int J Cardiovasc Res Vol: 4 Issue: 6

The Impact of Appropriate Use of Coronary Cardiac Computed Tomography on Downstream Resource Utilization and Patient Management

Tae Yang1,3, Mahmoud Assaad1, Ashley VanSlooten2, Meredith Mahan2 and Karthik Ananthasubramaniam1,3*
1Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
2Public Health Science, Henry Ford Hospital, Detroit, MI, USA
3Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI, USA
Corresponding author : Karthik Ananthasubramaniam
Henry Ford Hospital, Heart and Vascular Institute, K-14 2799 W. Grand Blvd, Detroit, MI 48202, USA
Tel: 313-916-4420; Fax: 313-916-8901
E-mail: [email protected]
Received: August 12, 2015 Accepted: November 14, 2015 Published: November 20, 2015
Citation: Yang T, Assaad M, VanSlooten A, Mahan M, Ananthasubramaniam K (2015) The Impact of Appropriate Use of Coronary Cardiac Computed Tomography on Downstream Resource Utilization and Patient Management. Int J Cardiovasc Res 4:6. doi:10.4172/2324-8602.1000240

Abstract

The Impact of Appropriate Use of Coronary Cardiac Computed Tomography on Downstream Resource Utilization and Patient Management

Background: The effects of appropriate use (AUC) of cardiac computed tomography angiography (CCTA) on downstream resource utilization, coronary angiography, revascularization, and medication changes are not well studied in daily practice.

Methods: Single center study to address AUC CCTA impact on downstream resource utilization. CCTA studies classified according to 2010 AUC as appropriate, inappropriate, or uncertain and its impact on downstream resource utilization and management was evaluated at 90 days and 1 year.

Results: Overall, 402 (87.8%) of the studies were appropriate, 37 (8.1%) were inappropriate, and 19 (4.2%) were uncertain. Additional cardiac testing at 90 days (5.2% vs. 10.8%, p=0.149) and 12 months (13.9% vs. 21.6%, p=0.205) were similar among all 3 groups. Significantly more patients in the inappropriate group underwent coronary angiography (21.6% vs. 9.7%, p=0.045), but revascularization rates were similar (8.1% vs. 5.0%, p=0.43). There was greater cardiac medication initiation once coronary artery disease was detected by CCTA (52.4% vs. 5.5%, p<0.0001) overall.

Conclusions: Our study did not show a downstream impact of AUCbased CCTA with regards to diagnostic testing or revascularization; however, higher referral for coronary angiography was found in the inappropriate group likely reflecting intrinsic higher risk group inappropriately referred to CCTA. Cardiac medication initiation to reduce perceived future risk was detected across all groups when coronary artery disease was detected by CCTA. Individual practices should audit their CCTA performance using AUC to identify areas for improvement in utilization of CCTA.

Keywords: Coronary computed tomography angiography; Appropriate use criteria; Coronary angiography; Utilization

Track Your Manuscript

Share This Page

Media Partners