Trial reportEuropean radiology2025
Cost-utility of computed tomography in patients with atypical chest pain clinically referred for invasive coronary angiography: randomised controlled trial.
Trial report in European radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00844220 (Coronary Artery Disease Management Using Multislice Computed Tomography and Magnetic Resonance Imaging), which is not on this map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Coronary Artery Disease Management Using Multislice Computed Tomography and Magnetic Resonance Imaging
Who cites it
1 citing paper in PubMed.
- U-shaped relationship between coronary artery calcification and underestimation of moderate coronary stenosis by coronary computed tomography angiography.Cardiovascular diagnosis and therapy · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComputed tomography (CT) is as safe as invasive coronary angiography (ICA) in the incidence of major adverse cardiovascular events in patients with atypical chest pain. However, the cost-utility of CT and ICA in healthcare after long-term follow-up is still unknown.
methodsA prespecified cost-utility analysis (CUA) of 329 patients with atypical chest pain from a single-centre randomised trial compared CT and ICA. The CUA was conducted from the health sector perspective up to a 3-year follow-up using quality-adjusted life years (QALYs) from the EQ-5D-3L questionnaire. Costs were obtained from each individual's outpatient and inpatient billing data and included cardiovascular medications, hospitalisations, emergency visits, cardiologist visits, and cardiac examinations. The analysis implemented 500 multiple imputations and 1000 bootstrapping iterations per imputed dataset, followed by calculating the net monetary benefit (NMB).
resultsThere was no significant difference in mean QALYs at either 1-year (CT: 0.69 (95% CI: 0.66-0.72); ICA: 0.71 (95% CI: 0.68-0.74); difference: -0.02 (-0.06 to 0.03)) or 3-year follow-up (CT: 2.09 (95% CI: 2.00-2.17); ICA: 2.11 (95% CI: 2.02-2.19); difference: -0.02 (95% CI: -0.14 to 0.12)), while the mean cost per patient was significantly lower in the CT compared with the ICA at both 1-year (difference (€): -1647.8, 95% CI: -2198.3 to 1093.3) and at 3-year follow-ups (difference (€): -1543.3, 95% CI: -2228.0 to -830.0). At a willingness-to-pay of €20,000/QALY, the mean incremental NMB of CT over ICA was €1256.5 (164.8-2331.8) at 1-year and €1202.0 (95% CI: -1378.7 to -3961) at 3-year follow-ups.
conclusionA CT-first strategy for the management of patients with atypical angina or chest pain was more cost-effective than a direct ICA strategy.
trial registrationClinicalTrials.gov NCT00844220. KEY POINTS: Question What is the cost-effectiveness of using CT compared to invasive coronary angiography (ICA) for diagnosing coronary artery disease in patients with atypical chest pain? Findings A CT-first diagnostic strategy was €1543 less costly per patient over a 3-year follow-up, yielding similar quality-adjusted life years compared to ICA. Clinical relevance CT offers a cost-effective, non-invasive alternative to ICA for patients with atypical chest pain, reducing healthcare costs significantly without compromising patient-reported outcomes or quality of life.
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