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 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
2018 - 2020
JD Schwalm is a Principal Investigator in the Knowledge Translation and Health Systems research program at PHRI, an Associate Professor, Department of Medicine (cardiology) at McMaster University, and an interventional cardiologist at Hamilton Health Sciences. He has published more than 50 peer-reviewed scientific papers and book chapters.
He completed medical school, internal medicine residency, and cardiology fellowship training at McMaster University, Ontario, followed by an interventional cardiology fellowship at McMaster and further training in that field at the University of Ottawa Heart Institute. He is a fellow of the Royal College of Physicians and Surgeons of Canada, with certification in internal medicine and cardiology.
Tej Sheth is a Scientist with the Perioperative and Surgery research program at PHRI, as well as a Principal Investigator in atherosclerosis imaging, an Associate Professor in the Department of Medicine at McMaster University, and a interventional cardiologist at Hamilton Health Sciences. His research interests include invasive and non-invasive coronary imaging modalities, including coronary angiography, optical coherence tomography, and CT coronary angiography. He is Director of the CT Angiographic Core Lab for the COMPASS CABG study and the COMPLETE trial at PHRI.
Tara McCready, PhD, oversees a variety of collaborative programs at PHRI, and serves as Project Manager for PHRI research studies and registries.
She was recruited to PHRI as a Program Director for the Canadian Network and Centre for Trials Internationally (CANNeCTIN), a national network funded by the CIHR/CFI Clinical Research Initiative program to improve the prevention and treatment of cardiac and vascular diseases and diabetes.
Previously the Executive Director of the Canadian Maternal, Infant, Child and Youth Research Network, Tara holds a PhD in Biochemistry and a MBA in Technology Commercialization from the University of Alberta.
Senior Reseach Coordinator
Jennifer Cunningham has more than 20 years’ experience working in research at PHRI. Starting with a few months assisting in research accounting in the then CCC Project Office in 1998, she began her PHRI career with study teams in 2000. Since then, Jennifer has had many roles at PHRI, from data management to her current role in senior coordination; and has worked on and managed multiple studies, from large international cardiovascular, national gastrointestinal, to policy changes and vulnerable/marginalized people studies within our own local community.
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