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Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary.

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Presentation on theme: "Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary."— Presentation transcript:

1 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Clinical Pathway for Stable Chest Pain Patients Evaluated With CCTA Followed by Stress ECG Patients with nondiagnostic coronary computed tomography angiography (CCTA) exams are evaluated with stress electrocardiography (ECG). CABG = coronary artery bypass graft; CAD = coronary artery disease; Cath = invasive cardiac catheterization; CP = chest pain; CTA+ = positive for 1- or 2-vessel coronary artery disease; CTA++ = positive for 3-vessel or left main coronary artery disease; CTA− = negative test; ETT = exercise treadmill test; ETT+ = positive stress test but no marked abnormalities; ETT++ = positive stress test with marked abnormalities (≥3 mm ST-segment depression or abnormal blood pressure response); ETT− = negative stress test; LM = left main disease; n-v = n-vessel disease; PCI = percutaneous coronary intervention. Figure Legend:

2 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Clinical Pathway for Stable Chest Pain Patients Evaluated With Stress ECG Followed by CCTA Patients with chest pain are evaluated with stress ECG and CTA and might be treated medically or undergo invasive procedures. Abbreviations as in Figure 1. Figure Legend:

3 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Clinical Pathway for Stable Chest Pain Patients Evaluated With Stress ECG, Echocardiography, or SPECT Patients with chest pain are evaluated with stress ECG, echocardiography, or single-photon emission computed tomography (SPECT) and might be treated medically or undergo invasive procedures. Abbreviations as in Figure 1. Figure Legend:

4 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Follow-Up Management for Patients With Lung Nodules CT = computed tomography; mgmt = management; Neg = negative; PET = positron emission tomography; Pos = positive; VATS = video-assisted thoracic surgery. Figure Legend:

5 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Cost-Effectiveness Plot for 55-Year-Old Men and Women With Atypical Chest Pain Cost-effectiveness plot for 55-year-old (A) men and (B) women with atypical anginal chest pain. Costs and quality-adjusted life- years (QALYs) are plotted on the horizontal and vertical axes, respectively. Each strategy is identified, but the efficient frontier— which is represented with a solid line—comprises only those strategies that maximize QALYs for a given cost or, equivalently, minimize cost for a given number of QALYs. ECHO = echocardiography; other abbreviations as in Figures 1 and 3. Figure Legend:

6 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Cost-Effectiveness Plot for 55-Year-Old Men and Women With Atypical Anginal Chest Pain—CTA Misclassification Sensitivity Analysis Cost-effectiveness plot for 55-year-old (A) men and (B) women with atypical anginal chest pain (CTA Misclassification Sensitivity Analysis). Cost-effectiveness of the CTA-based strategies does not change significantly when misclassification is considered. Abbreviations as in Figures 1, 3, and 5. Figure Legend:

7 Date of download: 7/8/2016 Copyright © The American College of Cardiology. All rights reserved. From: Clinical Outcomes and Cost-Effectiveness of Coronary Computed Tomography Angiography in the Evaluation of Patients With Chest Pain J Am Coll Cardiol. 2009;54(25):2409-2422. doi:10.1016/j.jacc.2009.10.012 Cost-Effectiveness of CTA–Stress ECG Strategy in 55-Year-Old Men and Women, Varying Cost of CCTA The cost-effectiveness of the CTA–stress ECG strategy becomes less favorable as the cost of CCTA rises. Abbreviations as in Figures 1 and 5. Figure Legend:


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