National cost savings, operational and safety benefits from use of magnetocardiography in the assessment of emergency department chest pain patients

• Published in: American heart journal plus 2024-09, Vol.45, p.100434, Article 100434
• Main Authors: Baugh, Christopher W., Pena, Margarita E., Takla, Robert B., Hadri, Ahmad O., Mace, Sharon E.
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Cardiac imaging; Chest pain; Cost savings; Emergency department; Magnetocardiography; Radiation-associated cancer risk; Research Paper; Risk stratification; Short stay admission; Stress tests
• ISSN: 2666-6022; 2666-6022
• DOI: 10.1016/j.ahjo.2024.100434

Patients frequently present to the emergency department (ED) with chest pain requiring further risk stratification. Traditional cardiac diagnostics such as stress testing may expose patients to ionizing radiation, may not be readily available, may take significant time for testing and interpretation, and adds cost to the workup. Magnetocardiography (MCG) is an alternative approach to assess candidates more quickly and efficiently than routine downstream testing. We created and ran 1000 trials of a Monte Carlo simulation. Using this simulation, we modeled the national annual impact by averting further cardiac diagnostics. All EDs in the United States. All ED adult patients with chest pain. Simulated use of MCG to reduce avoidable downstream cardiac diagnostics. Our primary outcome was to estimate the impact of an MCG-first strategy on the annual national cost savings among eligible patients in the ED. Our secondary outcomes were the estimated reduction in short-stay hospitalizations, cancer cases, and cancer deaths due to radiation exposure. An MCG-first strategy was estimated to save a mean (±SD) of $574 million (±$175 million) by avoiding 555,000 (±93,000) downstream cardiac diagnostic tests. This resulted in a national annual cumulative decrease of 500,000 (±84,000) hospitalizations, 7,600,000 (±1,500,000) bed hours, 409 (±110) new cancer diagnoses, and 210 (±56) new cancer deaths due to radiation exposure from avoidable cardiac diagnostics. If adopted widely and used consistently, an MCG-first strategy among eligible patients could yield substantial benefits by averting avoidable cardiac diagnostic testing. •Magnetocardiography is a rapid, low-risk, and cost-effective test for emergency department patients requiring additional cardiac diagnostics to evaluate myocardial ischemia.•A strategy using magnetocardiography as an initial screening test before conventional cardiac diagnostics could yield significant financial, operational, and safety benefits.•Access to Magnetocardiography is currently limited, preventing the realization of its benefits.