Non-invasive computed tomography (CT) to guide the selective use of invasive coronary angiography may be safe and less expensive compared with direct invasive angiography in stable symptomatic patients with suspected coronary artery disease. These findings from the CONSERVE Trial were presented Aug. 29 at ESC Congress 2016 in Rome.

The multicenter, controlled trial randomized 1,530 patients with indications for invasive angiography based on current guidelines to receive direct versus selective invasive coronary angiography. Selective invasive coronary angiography was driven by physician referrals based on initial CT results.

For the primary endpoint of 12-month major adverse coronary events, rates were the same (5 percent) in both groups, with the secondary endpoint of mean cardiovascular cost per patient being significantly lower in the selective vs. direct invasive coronary angiography arm ($2,883 vs. $6,031). Researchers also noted an 86 percent reduction in invasive coronary angiography using the selective strategy compared to the direct invasive angiography approach.

“Our study observed lower rates of invasive procedure, which were also associated with cost savings,” said Hyuk-Jae Chang, MD, PhD, from Yonsei University College of Medicine, Seoul, Republic of Korea. “The message from this trial is that, if we use coronary CT angiography as a gatekeeper to the catheterization lab in stable symptomatic patients with suspected coronary artery disease, we’ll reduce costs with sufficient safety.” 

Keywords: ESC Congress, Catheterization, Coronary Artery Disease, Tomography, X-Ray Computed, Angina, Stable, Angiography

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