October 26th, 2010
Updated Appropriate Use Criteria for Cardiac CT Published
An alphabet soup of medical organizations (ACCF, SCCT, ACR, AHA, ASE, etc.) have updated their appropriate use criteria for cardiac CT. The lengthy document includes an evaluation of 93 clinical scenarios and finds that cardiac CT is appropriate in 38% of them. Use of cardiac CT in the rest of the scenarios is deemed inappropriate or uncertain.
In general, cardiac CT angiography is deemed appropriate for use in patients with low or intermediate risk for CAD, while its use in high-risk patients, routine repeat testing, and general screening is deemed inappropriate. Calcium scanning is considered appropriate in people at intermediate risk or some low-risk people with a family history of heart disease.
“If we know a patient has existing heart problems or is at high risk for heart disease, doing the test isn’t generally going to add any valuable clinical information,” said Allen Taylor, the chair of the writing committee, in a press release issued by the ACC. “Ordering a test when a patient doesn’t need it — or won’t benefit — is not quality cardiac care.”
The full document is available online and will be co-published in JACC, Circulation, and the Journal of Cardiovascular Computed Tomography.