Cost-Effectiveness of the CADScor System in Low-Risk Patients Presenting to the Emergency Department with Chest Pain

Centers for Disease Control and Prevention AaHCSB. National Hospital Ambulatory Medical Care Survey: 2020 emergency department summary tables.

Kohn MA, Kwan E, Gupta M, Tabas JA. Prevalence of acute myocardial infarction and other serious diagnoses in patients presenting to an urban emergency department with chest pain. J Emerg Med. 2005;29:383–90.

Article  PubMed  Google Scholar 

Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021;144:e368–454.

PubMed  Google Scholar 

Mahler SA, Riley RF, Russell GB, et al. Adherence to an accelerated diagnostic protocol for chest pain: secondary analysis of the HEART pathway randomized trial. Acad Emerg Med. 2016;23:70–7.

Article  PubMed  Google Scholar 

Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342:1163–70.

Article  CAS  PubMed  Google Scholar 

Lee TH, Goldman L. Evaluation of the patient with acute chest pain. N Engl J Med. 2000;342:1187–95.

Article  CAS  PubMed  Google Scholar 

Winther S, Nissen L, Schmidt SE, et al. Diagnostic performance of an acoustic-based system for coronary artery disease risk stratification. Heart. 2018;104:928–35.

Article  PubMed  Google Scholar 

Winther S, Nissen L, Schmidt SE, Westra J, Andersen IT, Nyegaard M, Madsen LH, Knudsen LL, Urbonaviciene G, Larsen BS, Struijk JJ, Frost L, Holm NR, Christiansen EH, Botker HE, Bottcher M. Advanced heart sound analysis as a new prognostic marker in stable coronary artery disease. Eur Heart J Digit Health. 2021;2:279–89.

Article  PubMed  PubMed Central  Google Scholar 

Kolff AQ, Bom MJ, Knol RJ, van de Zant FM, van der Zee PM, Cornel JH. Discriminative power of the HEART score for obstructive coronary artery disease in acute chest pain patients referred for CCTA. Crit Pathw Cardiol. 2016;15:6–10.

Article  PubMed  Google Scholar 

Grandhi GR, Mszar R, Cainzos-Achirica M, et al. Coronary calcium to rule out obstructive coronary artery disease in patients with acute chest pain. JACC Cardiovasc Imaging. 2022;15:271–80.

Article  PubMed  Google Scholar 

Bittner DO, Mayrhofer T, Bamberg F, et al. Impact of coronary calcification on clinical management in patients with acute chest pain. Circ Cardiovasc Imaging. 2017;10:e005893.

Article  PubMed  PubMed Central  Google Scholar 

Priest VL, Scuffham PA, Hachamovitch R, Marwick TH. Cost-effectiveness of coronary computed tomography and cardiac stress imaging in the emergency department: a decision analytic model comparing diagnostic strategies for chest pain in patients at low risk of acute coronary syndromes. JACC Cardiovasc Imaging. 2011;4:549–56.

Article  PubMed  Google Scholar 

Espinosa G, Annapragada A. Cost-effectiveness of a novel blood-pool contrast agent in the setting of chest pain evaluation in an emergency department. AJR Am J Roentgenol. 2013;201:710–9.

Article  PubMed  Google Scholar 

Ge Y, Pandya A, Steel K, et al. Cost-effectiveness analysis of stress cardiovascular magnetic resonance imaging for stable chest pain syndromes. JACC Cardiovasc Imaging. 2020;13:1505–17.

Article  PubMed  Google Scholar 

Sutton BS, Bermingham SL, Diamantopoulos A, et al. Economic value of insertable cardiac monitors in unexplained syncope in the United States. Open Heart. 2021;8:e001263.

Article  PubMed  PubMed Central  Google Scholar 

Genders TS, Steyerberg EW, Alkadhi H, et al. A clinical prediction rule for the diagnosis of coronary artery disease: validation, updating, and extension. Eur Heart J. 2011;32:1316–30.

Article  PubMed  Google Scholar 

Schmidt SE, Winther S, Larsen BS, et al. Coronary artery disease risk reclassification by a new acoustic-based score. Int J Cardiovasc Imaging. 2019;35:2019–28.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Javanbakht M, Mashayekhi A, Hemami MR, Branagan-Harris M, Moloney E. Economic analysis of the CADScor system for ruling out coronary artery disease in England. Pharmacoecon Open. 2022;6:123–35.

Article  PubMed  Google Scholar 

Karady J, Mayrhofer T, Ivanov A, et al. Cost-effectiveness analysis of anatomic vs functional index testing in patients with low-risk stable chest pain. JAMA Netw Open. 2020;3: e2028312.

Article  PubMed  PubMed Central  Google Scholar 

Yau AA, Nguyendo LT, Lockett LL, Michaud E. The HEART pathway and hospital cost savings. Crit Pathw Cardiol. 2017;16:126–8.

Article  PubMed  PubMed Central  Google Scholar 

Kontos MC, Schmidt KL, McCue M, et al. A comprehensive strategy for the evaluation and triage of the chest pain patient: a cost comparison study. J Nucl Cardiol. 2003;10:284–90.

Article  PubMed  Google Scholar 

Pines JM, Hollander JE, Localio AR, Metlay JP. The association between emergency department crowding and hospital performance on antibiotic timing for pneumonia and percutaneous intervention for myocardial infarction. Acad Emerg Med. 2006;13:873–8.

Article  PubMed  Google Scholar 

Pines JM, Localio AR, Hollander JE, et al. The impact of emergency department crowding measures on time to antibiotics for patients with community-acquired pneumonia. Ann Emerg Med. 2007;50:510–6.

Article  PubMed  Google Scholar 

Badr S, Nyce A, Awan T, Cortes D, Mowdawalla C, Rachoin JS. Measures of Emergency department crowding, a systematic review. How to make sense of a long list. Open Access Emerg Med. 2022;14:5–14.

Article  PubMed  PubMed Central  Google Scholar 

Min JK, Gilmore A, Jones EC, et al. Cost-effectiveness of diagnostic evaluation strategies for individuals with stable chest pain syndrome and suspected coronary artery disease. Clin Imaging. 2017;43:97–105.

Article  PubMed  PubMed Central  Google Scholar 

Heijenbrok-Kal MH, Fleischmann KE, Hunink MG. Stress echocardiography, stress single-photon-emission computed tomography and electron beam computed tomography for the assessment of coronary artery disease: a meta-analysis of diagnostic performance. Am Heart J. 2007;154:415–23.

Article  PubMed  Google Scholar 

Madhavan MV, Redfors B, Ali ZA, et al. Long-term outcomes after revascularization for stable ischemic heart disease: an individual patient-level pooled analysis of 19 randomized coronary stent trials. Circ Cardiovasc Interv. 2020;13: e008565.

Article  PubMed  Google Scholar 

Bugiardini R, Manfrini O, De Ferrari GM. Unanswered questions for management of acute coronary syndrome: risk stratification of patients with minimal disease or normal findings on coronary angiography. Arch Intern Med. 2006;166:1391–5.

Article  PubMed  Google Scholar 

Bularga A, Lee KK, Stewart S, et al. High-sensitivity troponin and the application of risk stratification thresholds in patients with suspected acute coronary syndrome. Circulation. 2019;140:1557–68.

Article  PubMed  PubMed Central  Google Scholar 

Ko DT, Dattani ND, Austin PC, et al. Emergency department volume and outcomes for patients after chest pain assessment. Circ Cardiovasc Qual Outcomes. 2018;11: e004683.

Article  PubMed  Google Scholar 

Li S, Peng Y, Wang X, et al. Cardiovascular events and death after myocardial infarction or ischemic stroke in an older Medicare population. Clin Cardiol. 2019;42:391–9.

Article  PubMed  PubMed Central  Google Scholar 

Doost Hosseiny A, Moloi S, Chandrasekhar J, Farshid A. Mortality pattern and cause of death in a long-term follow-up of patients with STEMI treated with primary PCI. Open Heart. 2016;3: e000405.

Article  PubMed  PubMed Central  Google Scholar 

Morey JR, Jiang S, Klein S, et al. Estimating long-term health utility scores and expenditures for cardiovascular disease from the medical expenditure panel survey. Circ Cardiovasc Qual Outcomes. 2021;14: e006769.

Article  PubMed  Google Scholar 

Weiting H, Yaoxian AZ, Keong YK, et al. The clinical value and cost-effectiveness of treatments for patients with coronary artery disease. Health Econ Rev. 2022;12:56.

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