Use of Coronary Computed Tomographic Angiography to Guide Management of Patients With Coronary Disease

Abstract Background In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to explore the consequences of CCTA-assisted diagnos...

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Veröffentlicht in:	Journal of the American College of Cardiology 2016-04, Vol.67 (15), p.1759-1768
Hauptverfasser:	Williams, Michelle C., MD, Hunter, Amanda, MD, Shah, Anoop S.V., MD, Assi, Valentina, PhD, Lewis, Stephanie, PhD, Smith, Joel, PhD, Berry, Colin, MD, Boon, Nicholas A., MD, Clark, Elizabeth, Flather, Marcus, MD, Forbes, John, PhD, McLean, Scott, PhD, Roditi, Giles, MD, van Beek, Edwin J.R., MD, Timmis, Adam D., MD, Newby, David E., MD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Angina pectoris Cardiology Cardiovascular Cardiovascular disease Clinical Decision-Making Clinical outcomes Comparative Effectiveness Research Coronary Angiography - economics Coronary Angiography - methods Coronary Angiography - statistics & numerical data Coronary Artery Disease - complications Coronary Artery Disease - diagnosis Coronary Artery Disease - therapy Coronary Vessels - diagnostic imaging Female Heart attacks Humans Internal Medicine invasive coronary angiography Male Medical imaging Middle Aged Mortality myocardial infarction Myocardial Infarction - etiology Myocardial Infarction - mortality Myocardial Infarction - prevention & control Original Investigation Outcome and Process Assessment, Health Care preventive therapy Secondary Prevention - methods Secondary Prevention - statistics & numerical data Severity of Illness Index Tomography, X-Ray Computed - economics Tomography, X-Ray Computed - methods Tomography, X-Ray Computed - statistics & numerical data
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Zusammenfassung:	Abstract Background In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes. Methods In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records. Results Despite similar overall rates (409 vs. 401; p = 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios [HRs]: 0.39 [95% confidence interval (CI): 0.23 to 0.68]; p
ISSN:	0735-1097 1558-3597
DOI:	10.1016/j.jacc.2016.02.026