Coronary Computed Tomographic Angiography to Optimize the Diagnostic Yield of Invasive Angiography in Lower Risk Patients
Coronary artery disease (CAD) is the leading cause of death world-wide. The gold-standard test used to diagnose CAD is invasive coronary angiography. However, recent provincial data suggests that it is being over-utilized. Data from Local Health Integrated Network (LHIN) IV show that, in low-risk outpatients, the proportion of invasive angiograms without significant CAD is approximately 70%.
Coronary Computed Tomographic Angiography (CCTA) is a non-invasive test that is highly accurate for the detection of significant CAD in select populations and may be better suited for assessment of these low-risk patients.
We propose to use our LHIN wide central triage for invasive angiography to identify such low-risk patients and direct them to CCTA as a first step. By considering detailed patient characteristics through our triage process, we are working towards identifying the right diagnostic test for the right patient to improve health care delivery, reduce expenditures and patient risk.
Combined interventional and observational
JD Schwalm, Tej Sheth