Application 1105
Computed Tomography Coronary Angiogram - Multi-slice computed tomography coronary angiography in the visualisation of coronary arteries
Application No. | 1105 |
| Application Name | Computed Tomography Coronary Angiogram -Multi-slice computed tomography coronary angiography in the visualisation of coronary arteries |
| Advisory Panel | Dr John Atherton (Chair and MSAC member) Ms Sheila Rimmer (MSAC member) Professor Brendon Kearney (MSAC member) Dr Joan Kavallaris (Royal Australian College of General Practitioners nominee) Dr Greg Solomons (Royal Australian and New Zealand College of Radiology nominee) Professor Stephen Worthley (Cardiac Society of Australia and New Zealand nominee) Dr Matthew Bayfield (Australian Society of Cardiac and Thoracic Surgeons nominee) Mr Richard McCluskey (Consumer Health Forum nominee) |
| Date Received by MSAC Secretariat | 17 January 2006 |
| Stage 1 - Eligibility | Eligible |
| Stage 2 - Assessment | Completed |
| Stage 3 - Formulation of Advice to the Minister | This assessment was considered by the MSAC at the 23 November 2007 meeting. Based on the available evidence MSAC finds that MSCTCA is safer than coronary angiography (CA), by avoiding the risks associated with an invasive procedure. MSAC has considered the safety, effectiveness and cost-effectiveness for multi-slice computed tomography coronary angiography (MSCTCA) compared with invasive coronary angiography (CA) for the following indications: Indication 1 MSAC finds that MSCTCA is as effective as CA in ruling out significant coronary artery disease in patients with symptoms consistent with coronary ischaemia, with a high negative predictive value allowing CA to be avoided if MSCTCA reveals no significant disease. MSAC finds that in patients at low to intermediate risk of coronary artery disease, MSCTCA is cost-effective; however in patients at high risk, MSCTCA is not cost effective. If applied generally to patients with stable symptoms consistent with coronary ischaemia, but whose pre-test likelihood of disease is low to intermediate, MSCTCA appears to be cost-effective. Based on the available evidence, MSAC recommends that public funding is supported for MSCTCA on specialist referral of patients with stable symptoms consistent with coronary ischaemia who have a low to intermediate risk of coronary artery disease and are being considered for CA. Indication 2 There is limited evidence supporting the effectiveness of MSCTCA in the assessment of coronary anomaly or fistula, given that these conditions are rare and there has been no appropriate comparator. On the basis of limited evidence of effectiveness, the MSAC recommends public funding is supported for MSCTCA based on specialist referral of patients, requiring exclusion of coronary artery anomaly and fistula. Indication 3 No evidence was identified to assess the effectiveness of MSCTCA in the evaluation of coronary arteries in patients with cardiomyopathy. On the basis of insufficient evidence of effectiveness, the MSAC recommends that public funding is not supported for MSCTCA in the evaluation of coronary arteries in patients with cardiomyopathy. Indication 4 Limited but good quality evidence suggests that MSCTCA is as effective as CA in ruling out coronary artery disease in patients prior to non coronary cardiac surgery. Cost minimisation studies suggest MSCTCA is less costly than CA in ruling out coronary artery disease in patients prior to non coronary cardiac surgery. MSAC recommends that public funding for MSCTCA is supported in patients undergoing non-coronary cardiac surgery. |
| Stage 4 - Decision | Accepted by the Minister for Health and Ageing on 11 April 2008 |
| Stage 5 - Implementation | In Progress |
