Screening for coronary artery disease using CT calcium scoring
Parsons, J, Ellery, B
Record ID 32018000689
English
Authors' results and conclusions:
There is evidence that computed tomography (CT) calcium scoring can accurately predict cardiovascular events in asymptomatic individuals, and it has been shown to perform better than traditional risk factor assessment, although the magnitude of that difference in clinical terms is not clear. What has not been tested is whether screening for coronary artery disease (CAD) using CT calcium scoring has an impact on health outcomes, namely cardiovascular events. The risk associated with CT scanning from the radiation dose needs to be considered, as this is equivalent to approximately 50 chest x-rays. In addition, the impact on downstream tests and treatments (both increases and decreases) if this test is made widely available as a screening tool should also be taken into account.
Authors' recommendations:
The use of CT calcium scoring in symptomatic patients is not justified. Although CT calcium scoring is in widespread use for testing/screening asymptomatic patients in private clinical practice, it is of unproven clinical benefit or utility. A calcium score result will rarely change patient management; rather, patients with asymptomatic heart disease should be counselled in respect to behaviour modification and risk factor management. Therefore, HealthPACT does not support the use of CT calcium scoring in clinical practice at this time for screening asymptomatic patients. However, CT calcium scoring may have a role in identifying those patients deemed to be at intermediate risk of coronary artery disease, specifically for those patients in whom there is doubt as to whether or not to commence lipid lowering medication.
Details
Project Status:
Completed
Year Published:
2015
URL for published report:
Not Available
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Australia
MeSH Terms
- Coronary Artery Disease
- Disease Management
- Calcium
- Coronary Angiography
- Coronary Vessels
- Diagnostic Techniques, Cardiovascular
- Primary Prevention
- Risk Factors
- Tomography, X-Ray Computed
Keywords
- coronary calcium scoring
- screening
- cost effectiveness
Contact
Organisation Name:
Adelaide Health Technology Assessment
Contact Address:
School of Public Health, Mail Drop 545, University of Adelaide, Adelaide SA 5005, AUSTRALIA, Tel: +61 8 8313 4617
Contact Name:
ahta@adelaide.edu.au
Contact Email:
ahta@adelaide.edu.au
Copyright:
Adelaide Health Technology Assessment (AHTA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.