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Cardiac Link: a retrospective cohort study evaluating a clinical pathway for expedited cardiology referral

Authors :
Fahmeen J. Afgani
Connor T.A. Brenna
Kate Hanneman
Stephen Holzapfel
Corwin Burton
Paula J. Harvey
Elsie T. Nguyen
Source :
CMAJ Open. 10:E1000-E1007
Publication Year :
2022
Publisher :
CMA Impact Inc., 2022.

Abstract

Outpatients presenting with chest pain often face long wait times for cardiology consultation and subsequent investigation for obstructive coronary artery disease (CAD), during which adverse cardiovascular events may occur. Our objective was to describe the design of Cardiac Link, a coronary computed tomography angiogram (CCTA)-guided rapid-access program, and evaluate its effect on cardiology consultation wait times in patients who present to primary care physicians with stable chest pain.We conducted a retrospective cohort study at Women's College Hospital, Toronto, Ontario, Canada, between 2017 and 2020 involving eligible patients from the Family Practice Health Centre who underwent CCTA after presenting with stable chest pain or equivalent symptoms. Referring primary care physicians decided on a patient-by-patient basis to opt into the Cardiac Link program when requesting CCTA. Our primary outcome was measure of time from CCTA to cardiology consultation, and our secondary outcomes were measures of time to diagnosis from primary care consultation and CCTA booking time.Our analysis included 148 patients (Cardiac LinkWe determined that the Cardiac Link program reduced cardiology consultation wait times for symptomatic patients who were suspected of having CAD. Our study shows the viability of CCTA-guided rapid-access programs to expedite specialist consultation and reduce unnecessary referral for patients presenting to primary care physicians with stable chest pain.

Details

ISSN :
22910026
Volume :
10
Database :
OpenAIRE
Journal :
CMAJ Open
Accession number :
edsair.doi.dedup.....2fd198f53f60c840b18ee1f21eea5d71