"However, for a patient at low risk who has no symptoms and has a positive stress test result, our results suggest that preliminary coronary CTA rather than direct triage to cardiac catheterization is a cost effective alternative."
Cost-Effectiveness of Coronary CT Angiography in Evaluation of Patients Without Symptoms Who Have Positive Stress Test Results
Halpern EJ et al.
AJR 2010;194:1257-1262
"Performing coronary CTA before cardiac catherization is a cost effective strategy in the care of patients without symptoms who have positive stress test results when the probability that the patient has significant coronary artery disease is less than 50%. The false negative rate with this strategy compares favorably with the false negative rate of stress testing. The use of coronary CTA in this role can avoid many unnecessary cardiac catherization procedures."
Cost-Effectiveness of Coronary CT Angiography in Evaluation of Patients Without Symptoms Who Have Positive Stress Test Results
Halpern EJ et al.
AJR 2010;194:1257-1262
- Coronary Artery Aneurysms: Common Etiologies
- Kawasaki’s disease
- Atherosclerosis
- Takayasu’s vasculitis
- Infection
- Congenital
- Trauma
- Polyarteritis nodosa
- Loeys Dietz Syndrome
- May also be associated with cocaine use, SLE, syphilis and rheumatic fever - Coronary Artery Aneurysms: Common Causes
- There are a range of causes of coronary artery aneurysms that are listed in the following chart. The categories can best be defined as ranging from unusual vascular conditions (Kawasaki disease, Takayasu aortitis), to atherosclerotic disease to iatrogenic or traumatic causes (cardiac catheterization) to infection.
- Atherosclerotic disease is most common cause in the USA, while Kawasaki disease is most common cause worldwide - What is a coronary artery aneurysm?
- A coronary aneurysm is defined as a 50% or greater increase in coronary arterial diameter compared to adjacent arterial segments
- Most commonly involves the right coronary artery (RCA) and second most common site is the left anterior descending coronary artery (LAD). - Coronary Artery Aneurysms: Etiology
- Atherosclerosis
- Kawasaki disease
- Takayasu disease
- Cocaine use "Most commonly, these aneurysms involve the right coronary artery, followed by the left anterior descending coronary artery or left circumflex coronary artery."
CT Angiography of Coronary Artery Aneurysms: Detection, Definition, Causes and Treatment
Johnson PT, Fishman EK
AJR 2010; 195:928-934
"Patients with a moderate to high prior pretest probability of CAD should not undergo CT coronary angiography as a triage test prior to conventional angiography."
CT Coronary Angiography in Patients Suspected of Having Coronary Artery Disease: Decision Making from Various Perspectives in the Facr of Uncertainty
Genders TSS et al
Radiology 2009; 253:734-744 "According to cost-effectiveness model analyses our results suggest that CT coronary angiography performed as a triage test prior to conventional coronary angiography is cost saving and cost effective in men with a prior probability of CAD of less than 44% and in woman with a prior probability of CAD of less than 37%."
CT Coronary Angiography in Patients Suspected of Having Coronary Artery Disease: Decision Making from Various Perspectives in the Facr of Uncertainty
Genders TSS et al
Radiology 2009; 253:734-744
"Better strategies for risk stratification are needed to inform decisions and to increse the diagnostic yield off cardiac catheterization in routine clinical practice."
Low Diagnostic Yield of Elective Coronary Angiography Patel MR et al.
N Engl J Med 2010 March 11;362(10):886-895
- "MDCT represents a novel method of noninvasively assessing patent ductus arteriosus in adults that provides detailed anatomic information."
Morphologic Assessment of Patent Ductus Arteriosus in Adults using Retrospectively ECG-Gated Multidetector CT
Morgan-Hughes GJ et al.
AJR 2003; 181:749-754
