Early outcomes following integration of computed tomography (CT) coronary angiography service in an established cardiology practice in disease management.

Playford, David; Schwarz, Nisha; Williamson, Anna E; Duong, MyNgan; Shadmaan, Amied; Turner, Daneh; Behncken, Stuart; Phillips, Tom; Kearney, Leighton

Playford, David; Schwarz, Nisha; Williamson, Anna E; Duong, MyNgan; Shadmaan, Amied; Turner, Daneh; Behncken, Stuart; Phillips, Tom; Kearney, Leighton.

Affiliation

Playford D; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia; School of Medicine, The University of Notre Dame Australia, Fremantle, WA, Australia. Electronic address: david.playford@advaraheartcare.com.
Schwarz N; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia.
Williamson AE; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia.
Duong M; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia.
Shadmaan A; GE Healthcare, Parramatta, NSW, Australia.
Turner D; GE Healthcare, Parramatta, NSW, Australia.
Behncken S; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia.
Phillips T; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia.
Kearney L; Advara HeartCare, 3/245 Given Terrace, Paddington, QLD, 4064, Australia; Department of Cardiology, Austin Health, Melbourne, VIC, Australia; Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia.

J Cardiovasc Comput Tomogr ; 17(4): 254-260, 2023.

Article in En | MEDLINE | ID: mdl-37210242

ABSTRACT

BACKGROUND: Computed tomography coronary angiography (CTCA) is an established modality for the diagnosis and assessment of cardiovascular disease. However, price and space pressure have mostly necessitated outsourcing CTCA to external radiology providers. Advara HeartCare has recently integrated CT services within local clinical networks across Australia. This study examined the benefits of the presence (integrated) or absence (pre-integrated) of this "in-house" CTCA service in real-world clinical practice. METHODS: De-identified patient data from electronic medical records were used to create an Advara HeartCare CTCA database. Data analysis included clinical history, demographics, CTCA procedure, and 30-day outcomes post-CTCA from two age-matched cohorts: integrated (n â= â495) and pre-integrated (n â= â456). RESULTS: Data capture was more comprehensive and standardised across the integrated cohort. There was a 21% increase in referrals for CTCA from cardiologists observed for the integration cohort vs. pre-integration [n â= â332 (72.8%) pre-integration vs. n â= â465 (93.9%) post-integration, p â< â0.0001] with a parallel increase in diagnostic assessments including blood tests [n â= â209 (45.8%) vs. n â= â387 (78.1%), respectively, p â< â0.0001]. The integrated cohort received lower total dose length product [Median 212 (interquartile range 136-418) mGy∗cm vs. 244 (141.5, 339.3) mGy∗cm, p â= â0.004] during the CTCA procedure. 30-days after CTCA scan, there was a significantly higher use of lipid-lowering therapies in the integrated cohort [n â= â133 (50.5%) vs. n â= â179 (60.6%), p â= â0.04], along with a significant decrease in the number of stress echocardiograms performed [n â= â14 (10.6%) vs. n â= â5 (11.6%), p â= â0.01]. CONCLUSION: Integrated CTCA has salient benefits in patient management, including increased pathology tests, statin usage, and decreased post-CTCA stress echocardiography utilisation. Our ongoing work will examine the effect of integration on cardiovascular outcomes.

Subject(s)
Key words

CTCA; Cardiac CT service; Computed tomography coronary angiography; In-house service; Integrated CT services

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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Coronary Artery Disease / Cardiology Type of study: Prognostic_studies Limits: Humans Language: En Journal: J Cardiovasc Comput Tomogr Journal subject: ANGIOLOGIA / CARDIOLOGIA / RADIOLOGIA Year: 2023 Document type: Article Country of publication:

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