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Coronary Reactivity Assessment Is Associated With Lower Health Care-Associated Costs in Patients Presenting With

Ali Ahmad1,2, Michel T Corban1,3, James P Moriarty4

  • 1Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (A.A., M.T.C., Y.K., R.G., C.S.R., A.P., J.D.S., L.O.L., A.L.).

Circulation. Cardiovascular Interventions
|July 7, 2023
PubMed

Insights

Coronary reactivity testing (CRT) significantly reduced healthcare costs for patients with angina and nonobstructive coronary artery disease (ANOCA). This diagnostic approach lowers overall expenses and healthcare utilization over two years.

Area of Science:

  • Cardiology
  • Health Economics

Background:

  • Chest pain diagnosis and treatment incur substantial healthcare costs.
  • Angina and nonobstructive coronary artery disease (ANOCA) is a common condition linked to adverse cardiovascular events, repeat testing, and hospitalizations.
  • Coronary reactivity testing (CRT) can provide diagnostic certainty in ANOCA patients, but its financial impact is not well-studied.

Purpose of the Study:

  • To assess the effect of coronary reactivity testing (CRT) on healthcare-related costs in patients diagnosed with angina and nonobstructive coronary artery disease (ANOCA).

Main Methods:

  • A retrospective observational study matched ANOCA patients who underwent CRT with those who had only diagnostic coronary angiography (CAG).
  • Standardized, inflation-adjusted costs were collected and compared annually for two years post-index procedure.
  • The study included 207 patients in the CRT group and 207 in the CAG group.

Main Results:

  • The total healthcare cost was significantly higher in the CAG-only group ($37,804) compared to the CRT group ($13,679) over two years (P<0.001).
  • Major cost differences were observed in imaging (including CAG), procedures (PCI, CABG, thrombectomy), and diagnostic tests (blood tests, EKG).
  • Patients undergoing CRT demonstrated significantly reduced annual total costs and healthcare utilization.

Conclusions:

  • Coronary reactivity testing (CRT) in ANOCA patients is associated with significantly lower annual total costs and reduced healthcare utilization.
  • The findings support the potential integration of CRT into clinical practice for managing ANOCA patients.
  • CRT may offer a cost-effective diagnostic strategy for patients presenting with chest pain and nonobstructive coronary artery disease.
Abstract

Keywords:
chest paincoronary artery diseasecoronary circulationhealth care costsmicrovascular angina

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