ArticleEuropean radiology2018
Age- and sex-based resource utilisation and costs in patients with acute chest pain undergoing cardiac CT angiography: pooled evidence from ROMICAT II and ACRIN-PA trials.
Article in European radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 14 citations in OpenAlex.
- Coronary Computed Tomography Angiography to Exclude Acute Coronary Syndrome in Low-Risk Chest Pain Patients.Journal of cardiovascular development and disease · 2025Review
- Construction and evaluation of a triage assessment model for patients with acute non-traumatic chest pain: mixed retrospective and prospective observational study.BMC emergency medicine · 2025Observational
- Prognostic value of myocardial flow reserve derived by quantitative SPECT for patients with intermediate coronary stenoses.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023Article
- Diagnostic Value of Multislice Spiral CT Cardiothoracic Combined with Angiography in Acute Chest Pain.Journal of healthcare engineering · 2021Article
- Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET.Current cardiology reports · 2019Review
- Biochemical Markers for the Diagnosis and Monitoring of Wilson Disease.The Clinical biochemist. Reviews · 2019Review
- Differential Impact of Appropriate Use Criteria on the Association between Age and an Abnormal Stress Myocardial Perfusion SPECT.Cardiovascular innovations and applications · 2019Article
Corrections and comments
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Authors and funding
14 authors at 10 institutions in 2 countries.
Funding
Abstract
objectivesTo determine resource utilisation according to age and gender-specific subgroups in two large randomized diagnostic trials.
methodsWe pooled patient-specific data from ACRIN-PA 4005 and ROMICAT II that enrolled subjects with acute chest pain at 14 US sites. Subjects were randomized between a standard work-up and a pathway utilizing cardiac computed tomography angiography (CCTA) and followed for the occurrence of acute coronary syndrome (ACS) and resource utilisation during index hospitalisation and 1-month follow-up. Study endpoints included diagnostic accuracy of CCTA for the detection of ACS as well as resource utilisation.
resultsAmong 1240 patients who underwent CCTA, negative predictive value of CCTA to rule out ACS remained very high (≥99.4%). The proportion of patients undergoing additional diagnostic testing and cost increased with age for both sexes (p < 0.001), and was higher in men as compared to women older than 60 years (43.1% vs. 23.4% and $4559 ± 3382 vs. $3179 ± 2562, p < 0.01; respectively). Cost to rule out ACS was higher in men (p < 0.001) and significantly higher for patients older than 60 years ($2860-5935 in men, p < 0.001).
conclusionsCCTA strategy in patients with acute chest pain results in varying resource utilisation according to age and gender-specific subgroups, mandating improved selection for advanced imaging. KEY POINTS: • In this analysis, CAD and ACS increased with age and male gender. • CCTA in patients with acute chest pain results in varying resource utilisation. • Significant increase of diagnostic testing and cost with age for both sexes. • Cost to rule out ACS is higher in men and patients >60 years. • Improved selection of subjects for cardiac CTA result in more resource-driven implementation.
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