18th Interventional Cardiology Workshop New Frontiers in Interventional Cardiology

s of original contributions from NFIC 2017 353 Advances in Interventional Cardiology 2017; 13, 4 (50) 1-P Economic outcomes of the CAT-CAD randomised trial assessing Coronary Artery computed Tomography as the first-choice anatomic test for individuals with suspected significant Coronary Artery Disease Piotr N. Rudzinski, Mariusz Kruk, Cezary Kepka, Zofia Dzielinska, Jerzy Pregowski, Adam Witkowski, Witold Ruzyllo, Marcin Demkow Institute of Cardiology, Warsaw, Poland Bakground: Current recommendations indicate invasive coronary angiography (ICA) as the first-line anatomic test in stable patients with high probability of significant coronary artery disease (CAD). However, this approach effects in increased proportion of non-actionable ICAs (not followed by invasive treatment). Clinical efficacy and the safety of the strategy employing coronary computed tomography angiography (CCTA) as the first-choice imaging test in this population has been recently evaluated in the CAT-CAD randomised trial. Based on prospectively collected data we aimed to evaluate its economic outcomes. Methods: One hundred and twenty consecutive stable patients with indications to invasive CAD diagnosis were randomised 1 : 1 to undergo ICA versus CCTA as the firstline anatomic test. Outcomes were evaluated during the entire diagnostic and therapeutic course. Simultaneously, we counted the number of medical resources, such as: CCTAs, ICAs, percutaneous coronary interventions (PCIs), coronary artery bypass grafts (CABGs), functional tests, stents, clinical visits, hospital days. We estimated the cumulative cost for each strategy by multiplying medical resources by its standarised costs. Clinical Trials: NCT 02591992. Results: Economic analysis showed that the total cost of CAD diagnosis was significantly higher in the direct ICA group as compared to the CCTA group ($305,962 vs. $234,550), with the median per-patient cost of $2838 (2,838–2,838) vs. $409 (409–3,247), respectively (p = 0.0001). Similarly, the entire diagnostic and therapeutic course was significantly more expensive in the direct ICA group ($603,746 vs. $354,690), with the median per-patient cost of $2,838 (2,838–16,102) vs. $409 (409–9,930), respectively (p < 0.0001) (Figure 1). Conclusions: Application of CCTA as the first-line anatomic test in patients with suspected significant CAD decreased the total costs of diagnosis. This benefit can be achieved by reducing the number of invasive tests and hospitalisations.