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ObjectiveTo conduct a retrospective analysis of inpatients referred for invasive coronary angiography (ICA) at a tertiary centre, with suspected or confirmed acute coronary syndrome (ACS).MethodsA retrospective cohort study was conducted at Jersey General Hospital. We evaluated 198 inpatients referred for ICA with suspected or confirmed ACS over a 3-year period. Patients presenting with ST elevation myocardial infarction were excluded. The primary outcome was to identify the number of patients who did not require subsequent coronary intervention following ICA. Patient variables were measured to establish those who met European Society of Cardiology (ESC) criteria for consideration of CT coronary angiography (CTCA) as an alternative to ICA. Cost of care for those referred for ICA was calculated.ResultsICA demonstrated evidence of coronary heart disease requiring coronary intervention in 119 (60%) of the referred patients. 28 (35%) of the patients not requiring coronary intervention at ICA met ESC criteria for preassessment with CTCA. The cost of care for this subgroup was £9089 per patient. Inpatient CTCA was calculated at £376 per patient.ConclusionsLow-intermediate risk patients presenting with suspected or confirmed ACS to hospitals without onsite coronary revascularisation should be considered for in-hospital CTCA before consideration of ICA. Using CTCA as a gatekeeper for targeted ICA appears cost-effective, particularly for hospitals without the required onsite facilities.

Heart disease affects much of the world’s population, yet many people have no idea that they could have something wrong with them. An opportunity therefore exists for targeted screening for conditions such as cardiovascular disease, heart rhythm changes, valvular heart disease, structural abnormalities, and more subtle, rarer inherited heart conditions. At the same time, the rapid development of digital health technologies and clinical support systems is providing patients and their doctors access to augmented intelligence solutions to diagnose these conditions. This article will focus on how the emerging field of digital health technology can aid screening for heart disease and explore its usefulness in disease specific and population specific groups.

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eut. Since this was rarely true, the majority of these measurements cannot be used, and I have selected only the difference between the mentoglabellar and mento-breginatic to present in this paper. 8. Certain others; minimum frontal, interstephanic and biasterianic were at first made, but later dropped.A careful perusal of Peterson's and Robertson's works is re-commended to anyone desiring to cany on. such investigations.1, 2 and 5 are done with the tape. 2, 3, 6 and 7 with the cephaloineter.