Nav: Home

The CONSERVE trial: Noninvasive imaging can guide more selective invasive coronary angiography

August 29, 2016

Rome, Italy 29 August 2016 - In stable symptomatic patients with suspected coronary artery disease, a strategy of using non-invasive computed tomography (CT) to guide the selective use of invasive coronary angiography was safe, and less expensive compared with direct invasive angiography.

Findings of the CONSERVE (Coronary Computed Tomographic Angiography for Selective Cardiac Catheterization) trial, presented in a Hot Line session at ESC Congress 2016, showed the CT-guided strategy was associated with no differences in major adverse cardiovascular events (MACE), and resulted in an 86% reduction in invasive coronary angiography (ICA) compared to the direct invasive angiography approach.

"Our study observed lower rates of invasive procedure, which were also associated with cost savings," commented investigator Hyuk-Jae Chang, MD, PhD from Yonsei University College of Medicine, in 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."

The randomized, multicenter, controlled trial included 1,530 patients with indications for invasive angiography, based on current guidelines.

They were randomized to direct versus selective invasive coronary angiography, the latter driven by physician referrals based on initial results of the CT.

For the primary endpoint of 12-month MACE, rates were 5% in both groups, with the secondary endpoint of mean cardiovascular cost per patient being significantly lower in the selective versus direct invasive coronary angiography arm ($2,883 vs $6,031).

There was a >$3000 cost savings per person in this trial over 12 months using medicare costs. If we account for the 4.6M caths that are done (3.6 in the outpatient setting), we can see that math works out to >$10B each year.

In addition to being economically meaningful, the significant reduction in invasive procedures is clinically important, said Prof. Chang "CT guided strategy may uncouple the diagnosis - treatment cascade of ICA which promote excess revascularization and subsequently expose patients to non-negligible risk related to invasive procedure."
-end-
Notes to editors

Sources of funding: The CONSERVE trial was funded by an investigator-initiated unrestricted grant from GE healthcare (Princeton, New Jersey) and Severance Hospital of Yonsei University (Seoul, Korea).

Disclosures: The investigators have no financial conflicts regarding this study.

ESC Press Office

For background information, please contact the ESC Press Office at media@escardio.org.

For press enquiries, please contact, the Media & Press Coordinator, Jacques Olivier Costa: +393427028575

For independent comment on site, please contact the ESC Spokesperson coordinator, Celine Colas: +393402405148

To access all the scientific resources from the sessions during the congress, visit ESC Congress 365.

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 120 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2016

ESC Congress is the world's largest gathering of cardiovascular professionals contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2016 takes place 27 to 31 August at the Fiera di Roma in Rome, Italy. The scientific programme is here. More information is available from the ESC Press Office at press@escardio.org

This press release accompanies both a presentation and an ESC press conference at the ESC Congress 2016. Edited by the ESC from material supplied by the investigators themselves, this press release does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the presenter.

European Society of Cardiology

Related Strategy Articles:

A new strategy for the synthesis of complex natural products
Chemists from the University of Basel have succeeded in synthesizing two complex natural products from the group of dithiodiketopiperazines (DTPs).
Leishmania virulence strategy unveiled
A team from the Institut National de la Recherche Scientifique (INRS) has made a scientific breakthrough regarding the virulence strategy employed by the Leishmania parasite to infect cells of the immune system.
Canada's new dementia strategy needs commitment to be successful
Canada's new national dementia strategy can be successful with sustained political will, adequate funding, measurable targets and a commitment from all Canadians to achieve its goals, argues an editorial in CMAJ (Canadian Medical Association Journal) http://www.cmaj.ca/lookup/doi/10.1503/cmaj.190929.
A simple strategy to improve your mood in 12 minutes
We all have a remedy -- a glass of wine or a piece of chocolate -- for lifting our spirits when we're in a bad mood.
New therapeutic strategy to treat Alzheimer's
Researchers from the Institute of Neurosciences of the University of Barcelona (UBNeuro) have identified a potential therapeutic strategy to treat Alzheimer's, according to a study published in Journal of Neuroscience.
More Strategy News and Strategy Current Events

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Erasing The Stigma
Many of us either cope with mental illness or know someone who does. But we still have a hard time talking about it. This hour, TED speakers explore ways to push past — and even erase — the stigma. Guests include musician and comedian Jordan Raskopoulos, neuroscientist and psychiatrist Thomas Insel, psychiatrist Dixon Chibanda, anxiety and depression researcher Olivia Remes, and entrepreneur Sangu Delle.
Now Playing: Science for the People

#537 Science Journalism, Hold the Hype
Everyone's seen a piece of science getting over-exaggerated in the media. Most people would be quick to blame journalists and big media for getting in wrong. In many cases, you'd be right. But there's other sources of hype in science journalism. and one of them can be found in the humble, and little-known press release. We're talking with Chris Chambers about doing science about science journalism, and where the hype creeps in. Related links: The association between exaggeration in health related science news and academic press releases: retrospective observational study Claims of causality in health news: a randomised trial This...