Objective: To compare computed tomographic an-giography (CTA) and invasive coronary angiography (ICA) in terms of quality of life and cost-effectiveness in patients with suspected coronary artery disease (CAD) in a private versus public hospital in Romania. Methods: This study includes patients with stable angi-na and intermediate risk of CAD. Patients were enrol-led in the public or private hospital and randomized to CCTA or ICA, with follow-up at 1 year. Comparison of quality of life (EQ-5D-3L Health Index at baseline and follow-up) and cost-effectiveness analysis (TreeAge software, cost per major adverse cardiovascular event and cost per quality adjusted life year) were performed. Results: The 101 patients at the private hospital were randomized to either ICA (54 patients; mean age 59.5 years) or CCTA (47 patients; mean age 56.1 years). The 23 patients at the public hospital were randomized to ICA (13 patients; mean age 60.3 years) or CCTA (10 patients; mean age 55.0 years). ICA and CCTA did not significantly differ in mean health index differen-ce from baseline to follow-up at the private hospital (mean 0.14 SD 0.18; mean 0.10 SD 0.20 respectively; p=0.29). However, the mean initial evaluation cost for CCTA was significantly lower than that of ICA, and all costs were significantly different for the private versus public hospital.
Conclusions: Coronary CT angiography and invasive coronary angiography had similar effects on quality of  life at the private hospital, with lower costs associated with CCTA. Additionally, the initial evaluations had different costs associated with the private compared to public hospital, suggesting an importance of institution type on cost-effectiveness.