Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease

Publication date: Available online 10 February 2017
Source:Clinical Imaging
Author(s): James K. Min, Amanda Gilmore, Erica C. Jones, Daniel S. Berman, Wijnand J. Stuijfzand, Leslee J. Shaw, Ken O'Day, Ibrahim Danad
PurposeTo determine lifetime cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain and suspected coronary artery disease (CAD).MethodsExercise treadmill testing (ETT), stress echocardiography (SE), myocardial perfusion scintigraphy (MPS), coronary computed tomographic angiography (CCTA), and invasive coronary angiography (ICA) were assessed alone, or in succession to each other.ResultsInitial ETT followed by imaging wherein ETT was equivocal or unable to be performed appeared more cost-effective than any strategy employing initial testing by imaging.ConclusionAs pre-test likelihood of CAD varies, different modalities including SE, CCTA, and MPS result in improved costs and enhanced effectiveness.



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