A Review of a Tertiary Referral Centre's CT Coronary Angiography Programme

Area of Science:

• Cardiology
• Radiology
• Health Services Research

Background:

• Outpatient CT coronary angiogram (CTCA) is a key diagnostic tool for stable chest pain.
• Understanding the impact of waiting times on patient outcomes and service delivery is crucial for optimizing cardiac care pathways.

Purpose of the Study:

• To evaluate the association between outpatient CTCA waiting times and patient outcomes.
• To assess the implications for service provision within cardiology and emergency departments.

Main Methods:

• Retrospective analysis of 172 outpatient CTCAs for stable chest pain in 2017.
• Data collection included major adverse cardiovascular events (MACE), emergency department presentations, cardiology outpatient attendance, treatment alterations, and revascularization rates.

Main Results:

• A low rate of MACE (1 non-fatal MI) and revascularization (7 percutaneous coronary interventions) was observed.
• 12.2% of patients required prognostic treatment alteration, averaging 10.4 months post-CTCA.
• 22.1% attended outpatient clinics before scan completion, indicating potential administrative inefficiencies.

Conclusions:

• The low MACE rate suggests appropriate patient selection for CTCA in this cohort.
• Delays in treatment modification and pre-scan outpatient attendance highlight areas for improved administrative support and service coordination.