What is the role of coronary computed tomography angiography (CCTA) in the emergent management of coronary artery disease (CAD)?

Updated: Dec 21, 2017
  • Author: Eugene C Lin, MD; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

In a multicenter trial [19] of 1000 patients presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndromes, incorporation of CCTA into the triage strategy improved the efficiency of clinical decision making (significantly higher rates of discharge from the ED and reduced mean length of hospital stay) compared with standard evaluation. However, incorporation of CCTA resulted in an increase in downstream testing and radiation exposure with no decrease in overall costs of care. In a meta-analysis of 4 randomized controlled trials, [20] the use of CCTA in the ED was associated with decreased ED cost and length of stay but a 2% increase in invasive coronary angiography and revascularization (whether the increased rate of invasive procedures leads to improved patient outcomes is unknown).


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