Could those patients have avoided the cath lab if they had gotten a CT angiogram instead?
Dr. Min: Probably. Because we know that CT’s negative predictive value approaches 100% — so you literally exclude significant coronary artery disease with a 99% certainty. There was a study that looked at that out of Chicago, where they took patients with moderately abnormal stress tests and used CT to arbiter that. And if that person had severe coronary disease in the area of interest of the nuclear scan then they proceeded to angiography, but otherwise were managed medically — and there was an 80% reduction in catheterizations!
