Optimizing CAD diagnosis in China with CT angiography

Area of Science:

• Cardiovascular Imaging
• Health Economics
• Medical Technology Assessment

Background:

• Coronary artery disease (CAD) diagnosis in China faces challenges due to high prevalence and limited resources.
• Coronary computed tomography angiography (CTA) offers a potential solution to minimize invasive procedures for intermediate-risk patients.
• CTA can improve cost-effective diagnosis and patient access to CAD evaluation.

Purpose of the Study:

• To evaluate the cost and efficiency of using CTA in conjunction with CA for diagnosing suspected CAD in China.
• To optimize the diagnostic strategy for patients with intermediate pretest probability of significant CAD.

Main Methods:

• A cost-consequences analysis was performed from the perspective of Fuwai Hospital, Beijing.
• A decision-analytic model compared CA-only strategy versus CTA followed by CA strategy.
• The model focused on patients indicated for CA with intermediate pretest probability of significant CAD.

Main Results:

• The combined CTA and CA strategy resulted in cost savings of US $597 per patient compared to CA alone.
• The hospital cost per confirmed CAD diagnosis was US $8,103 for CTA-CA versus US $9,148 for CA-only.
• CTA sensitivity and CA unit cost were key influential parameters; cost savings ranged from US $461 to US $768 per patient.

Conclusions:

• Implementing CTA in China for intermediate-risk patients indicated for CA can optimize the selection for invasive procedures.
• This strategy may lead to significant cost savings for Chinese hospitals.
• CTA integration can enhance the efficiency and accessibility of CAD diagnosis.