Non-Cardiac Incidental Results Rarely Clinically Significant
But study suggests investigating findings can lead to complications and add to health care costs
TUESDAY, Oct. 6 (HealthDay News) -- Non-cardiac findings found by cardiac computed tomography (CT) are usually not clinically significant and have no impact on death rates, but can lead to complications and add to health care costs, according to a study in the Oct. 13 Journal of the American College of Cardiology.
Jimmy MacHaalany, M.D., and colleagues from the University of Ottawa investigated the incidence, clinical significance, and costs associated with non-cardiac incidental findings in patients undergoing cardiac CT.
The researchers found that 41.5 percent of patients had non-cardiac incidental findings, 1.2 percent had clinically significant findings, and 7.0 percent had indeterminate findings. After a median follow-up of 18.4 months, none of the indeterminate findings became clinically significant. Although three cancers were found on follow-up CT scans, none had been observed on the initial scan. Non-cardiac incidental findings did not independently predict non-cardiac death after adjusting for age, and death rates from cancer or non-cardiac causes were similar regardless of the presence of incidental findings. However, one patient had a major complication associated with investigating an incidental finding that required hospitalization, and direct costs of $83,035.
"It is clear that non-cardiac incidental findings on cardiac CT studies are very common and lead to additional diagnostic tests, increased risk from radiation exposure and biopsies, and definite costs," write the authors of an accompanying editorial. "Since there is no professional consensus about the approach to reading cardiac CT scans for non-cardiac findings, we suggest that the patient's concerns and preferences should be taken into consideration, as they would in any 'close call'."
Several authors reported financial relationships with pharmaceutical and biotechnology companies.