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Influence of coronary computed tomographic angiography on patient treatment and prognosis in patients with suspected stable angina pectoris.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2011 May 15; Vol. 107 (10), pp. 1473-9. Date of Electronic Publication: 2011 Mar 21. - Publication Year :
- 2011
-
Abstract
- We evaluated the influence of coronary computed tomographic angiography (CTA) as a first-line diagnostic test on patient treatment and prognosis. A total of 1,055 consecutive patients with suspected stable angina pectoris (mean age 55 ± 10 years, 56% women) and a low to intermediate pretest likelihood of coronary artery disease (CAD) were included in the present study. The patients were followed for a median of 18 months. The use of downstream diagnostic testing and medical therapy after CTA were recorded. The CTA result was normal in 49%, and nonobstructive and obstructive CAD (≥50% stenosis) was demonstrated in 31% and 15% of the patients, respectively. Coronary CTA was inconclusive in 5% of the patients. The use of antiplatelet therapy decreased with normal findings from CTA, and the use of antiplatelet and lipid-lowering agents increased in patients with CAD. Additional testing was performed in 2% of patients with normal CTA findings and in 7% and 82% of patients with nonobstructive or obstructive CAD, respectively. No patients without CAD, 0.9% of patients with nonobstructive CAD, and 1.9% of patients with obstructive CAD met the primary end point (cardiovascular death and myocardial infarction, p = 0.008). No patients without CAD, 1.5% of patients with nonobstructive CAD, and 30% patients with obstructive CAD met the secondary end point (cardiovascular death, myocardial infarction, and coronary revascularization, p <0.0001). In conclusion, in patients suspected of having angina, the findings from CTA influence patient treatment without resulting in excessive additional testing. Coronary CTA provides important prognostic information, with excellent intermediate-term outcomes in patients with normal CTA findings.<br /> (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Subjects :
- Angina Pectoris diagnosis
Angina Pectoris drug therapy
Coronary Artery Disease diagnostic imaging
Female
Follow-Up Studies
Humans
Hypolipidemic Agents therapeutic use
Male
Middle Aged
Platelet Aggregation Inhibitors therapeutic use
Prognosis
Angina Pectoris diagnostic imaging
Coronary Angiography
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 107
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 21420047
- Full Text :
- https://doi.org/10.1016/j.amjcard.2011.01.024