Deaths and medical expenses due to coronary artery diseases are increasing every year. Chest pain is an important symptom of coronary artery diseases, but may occur from various causes and differential diagnosis cannot be made easily with symptoms only.

Coronary angiography(CAG) is the gold standard for making a definite diagnosis for coronary artery diseases and enables both diagnosis and treatment together. However, it is an invasive procedure and there are risks of vessel injury or death during the procedure. In addition, hospitalization is required and the procedure cost is expensive. 

Thus, many non-invasive differential diagnosis methods are being performed including CT coronary angiography (CTCA), myocardial SPECT, stress electrocardiogram(ECG) for patients with chest pain before implementing CAG. Medical expenses for these non-invasive tests are increasing, but there is a lack of studies on whether the procedure selection is suitable or which test is the most appropriate for specific subjects. 

In this study, the accuracy and economic evaluations of non-invasive diagnosis methods for coronary artery diseases were analyzed using retrospective medical records of patients who visited the cardiology outpatient clinic with chest pain.