CADScor system for ruling out coronary artery disease in people with symptoms of stable coronary artery disease

The technology described in this briefing is CADScor. It can be used to rule out coronary artery disease in people aged 40 years or over with symptoms of stable coronary artery disease.

The innovative aspect is that it is a new acoustic method of detecting coronary artery disease by recording coronary murmurs caused by turbulent flow and myocardial movement.

The intended place in therapy would be as a stable coronary artery disease rule-out method after first clinical evaluation (clinical history, physical examination, 12-lead ECG) but before CT coronary angiography (CTCA).

The main points from the evidence summarised in this briefing are from 2 prospective observational studies involving a total of 1,900 adults referred to coronary computed tomography or invasive coronary angiography because of symptoms suggestive of stable coronary artery disease. Based on the reported diagnostic accuracy of CAD-score for coronary artery disease, they show the CADScor system can allow risk stratification that is superior to clinical risk scores.

Key uncertainties around the evidence are that it is limited in quantity, with no data from an NHS setting. Evidence supporting its diagnostic accuracy is in people of European family origin only.

The cost of CADScor system is £4,460 per unit (exclusive of VAT). The technology may be resource releasing in the long term if it reduces the number of people being referred for CTCA or other alternative diagnostic investigations.