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Impact of atherosclerosis imaging-quantitative computed tomography on diagnostic certainty, downstream testing, coronary revascularization, and medical therapy: the CERTAIN study.
- Source :
- European Heart Journal - Cardiovascular Imaging; Jun2024, Vol. 25 Issue 6, p857-866, 10p
- Publication Year :
- 2024
-
Abstract
- Aims The incremental impact of atherosclerosis imaging-quantitative computed tomography (AI-QCT) on diagnostic certainty and downstream patient management is not yet known. The aim of this study was to compare the clinical utility of the routine implementation of AI-QCT versus conventional visual coronary CT angiography (CCTA) interpretation. Methods and results In this multi-centre cross-over study in 5 expert CCTA sites, 750 consecutive adult patients referred for CCTA were prospectively recruited. Blinded to the AI-QCT analysis, site physicians established patient diagnoses and plans for downstream non-invasive testing, coronary intervention, and medication management based on the conventional site assessment. Next, physicians were asked to repeat their assessments based upon AI-QCT results. The included patients had an age of 63.8 ± 12.2 years; 433 (57.7%) were male. Compared with the conventional site CCTA evaluation, AI-QCT analysis improved physician's confidence two- to five-fold at every step of the care pathway and was associated with change in diagnosis or management in the majority of patients (428; 57.1%; P < 0.001), including for measures such as Coronary Artery Disease-Reporting and Data System (CAD-RADS) (295; 39.3%; P < 0.001) and plaque burden (197; 26.3%; P < 0.001). After AI-QCT including ischaemia assessment, the need for downstream non-invasive and invasive testing was reduced by 37.1% (P < 0.001), compared with the conventional site CCTA evaluation. Incremental to the site CCTA evaluation alone, AI-QCT resulted in statin initiation/increase an aspirin initiation in an additional 28.1% (P < 0.001) and 23.0% (P < 0.001) of patients, respectively. Conclusion The use of AI-QCT improves diagnostic certainty and may result in reduced downstream need for non-invasive testing and increased rates of preventive medical therapy. [ABSTRACT FROM AUTHOR]
- Subjects :
- DIAGNOSTIC imaging
RESEARCH funding
COMPUTED tomography
QUESTIONNAIRES
ARTIFICIAL intelligence
ATHEROSCLEROSIS
DIAGNOSTIC errors
TREATMENT effectiveness
DESCRIPTIVE statistics
MYOCARDIAL revascularization
LONGITUDINAL method
CROSSOVER trials
RESEARCH
CORONARY angiography
CORONARY artery disease
COMPARATIVE studies
PREVENTIVE health services
Subjects
Details
- Language :
- English
- ISSN :
- 20472404
- Volume :
- 25
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- European Heart Journal - Cardiovascular Imaging
- Publication Type :
- Academic Journal
- Accession number :
- 177659505
- Full Text :
- https://doi.org/10.1093/ehjci/jeae029