National Trends in Coronary Artery Disease Imaging: Associations With Health Care Outcomes and Costs
Authors' conclusion
Imaging investigations for CAD are increasing. Greater regional increases in CCTA were associated with fewer hospitalizations for myocardial infarction and a more rapid decline in CAD mortality.
Study context
- Population
- Investigations for coronary artery disease (CAD) from a national database linked to hospital admission and mortality registries, 2012–2018
- Participants
- 1,909,314 investigations
- Exposure
- Imaging trends before vs after the NICE CG95 recommendation of coronary computed tomography angiography (CCTA) as first-line test
- Outcome
- Impact of temporal trends in imaging use on CAD outcomes following the CG95 recommendations
Methodological detailsnational database, interrupted time-series analysis
- National database
- Interrupted time-series analysis
Main finding
As reported in the abstract
- Annualized per capita growth in investigations for CAD
- 4.8%
- Costs (£ million/100,000 population/year)
- £0.35
- Cost increase per year (mirroring inflation 2.5%/year)
- 2.8%/year
- CG95 and CCTA use, exp[β]
- 1.10 (95% CI 1.03-1.18)
- CG95 and invasive coronary angiography, potential modest fall, exp[β]
- 0.997 (95% CI 0.993-1.00)
- CCTA growth vs invasive catheter angiography reduction across regions, Kendall Tau (P = 0.08)
- −0.19
- CCTA growth vs CV mortality, Kendall Tau (P = 0.045)
- −0.21
- CCTA growth vs ischemic heart disease deaths, Kendall Tau (P = 0.042)
- −0.22
- CCTA growth vs all-cause mortality, apparent trend, Kendall Tau (P = 0.07)
- −0.19
Observational data: associations, not effects.
Original publication
National Trends in Coronary Artery Disease Imaging: Associations With Health Care Outcomes and Costs. JACC Cardiovasc Imaging. Published 11 January 2023. doi:10.
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