A less invasive - and less costly - approach to testing for heart disease

A study by doctors at Thomas Jefferson University in Philadelphia suggests that many people who have stress tests that point to possible heart disease could be fully diagnosed with a CT scan rather than a cardiac catheterization. The CT scans would be less invasive and less costly, according to the research published in the American Journal of Roentgenology.

“Patients with positive stress test results, but no heart-related symptoms … often receive referrals for cardiac catheterization for evaluation” of coronary artery disease, said Ethan J. Halpern, the lead author and a professor in the department of radiology at Jefferson Medical College.  Coronary CT, he said, “is an alternative, non-invasive diagnostic imaging test that can be used to effectively triage these patients.”

The researchers noted that patients who get stress tests but are estimated to have less than a 50 percent chance of actually having significant coronary artery disease are good candidates for CT scans. They estimated that if half of the patients tested actually had heart disease, performing a CT scan would save an average of $789 per patient. (A positive result on a scan would still need to be confirmed by a cardiac catheterization.)

An Inquirer analysis of 2008 hospital billing data from Philadelphia and its four suburban Pennsylvania counties identified 9,991 cases in which a cardiac catheterization was the principle procedure performed during a hospitalization.