Findings from a new study by Anna M. Chang, MD, University of Pennsylvania, PA, USA, using the Siemens SOMATOM^® Definition suggest that integrating computed tomography angiography (CTA) in the clinical routine safely and effectively stratifies high- and low-risk patients admitted to the emergency room (ER) for acute chest pain [1]. She and her team scanned patients in the ER for acute coronary syndrome (ACS) using high-resolution CTA and showed that negative scans were a quick and accurate way of identifying patients who could safely be discharged from the hospital.

Dr. Chang is in good company in this opinion. Udo Hoffmann, MD, from the Diagnostic Radiology Department at Massachusetts General Hospital in Boston, and John Lesser, MD, from the Minneapolis Heart Institute, Minneapolis, MN, have also been successfully using CTA in their ER departments for low-risk patients. “These are patients who traditionally would come into the emergency department and we'd have to admit them to the hospital or send them to the observation unit before they could be sent home,” Dr. Lesser states. “Now these patients can be sent home immediately from the emergency room."

“The challenge is,” explains Dr. Hoffmann, “that only 10 to15 percent of patients develop ACS out of about 80 percent of all patients with a lead symptom of chest pain.” This over triage has enormous economic implications for the U.S. healthcare system, with an estimated US$8 billion in annual costs [2]. In terms of cost, Chang and colleagues report that CTA is significantly more cost-effective than traditional methods (standard of care) for identifying at-risk-patients [3]. The cost of screening with immediate CTA in the ER was at only US$1,240, while the cost for the current standard of care, including stress testing, measuring serial biomarkers, and monitoring in the observation unit was more than US$4,000 per patient. Dr. Lesser, who also uses a SOMATOM Definition with the CT Acute Care Engine, confirms these numbers, since he and his team are currently working on a similar multicenter trial. “With the use of CTA in the ER we cut time down to two hours and reduce cost by 50 percent,” he states.

With integrating the SOMATOM Definition, in combination with the CT Acute Care Engine, into the clinical pathway it is possible to safely and effectively rule out acute coronary syndrome in the ER, which reduces time by up to 80 percent while cutting cost by 50 percent – making this a most attractive alternative to the current standard of care.