Chest pain patients hospitalized more often if they do not have Coronary CT Scans

August 1, 2013 — Patients presenting with chest pain spend less time in the hospital and are admitted less often if they undergo coronary CT angiography (CCTA) rather than standard care, according to a new study in the Journal of the American College of Cardiology.

The findings offer fresh evidence that the use of CCTA can improve the triage of chest pain patients, said lead author Dr. Michael Poon from the William Beaumont School of Medicine in Royal Oak, MI, and colleagues from Stony Brook University School of Medicine in Stony Brook, NY, and the University of Toronto in Canada.

The group studied the association between routine CCTA and hospital admissions, length of stays, and recidivism rates in chest pain patients presenting to the emergency department. They compared 984 individuals undergoing CCTA (64-detector-row MDCT, median radiation dose of 5.88 mSv) with a matched cohort of 984 chest pain patients who received standard care at the hospital, which included cardiac monitoring with electrocardiograms and blood tests (JACC, August 6, 2013).

Those who received standard evaluation had a 5.5 times greater risk of being hospitalized, and an emergency department stay that was 1.6 times longer than those who had undergone CCTA, the authors reported.

CCTA is favorable for triaging patients with chest pain, greatly reducing the utilization of healthcare resources and saving significant costs, time, and unnecessary hospital admissions by ruling out significant stenosis or imminent danger of a cardiac event, said Poon, a professor of radiology, medicine, and emergency medicine at Beaumont.