Coronary artery diseaseUsefulness of Multislice Computed Tomographic Coronary Angiography to Identify Patients With Abnormal Myocardial Perfusion Stress in Whom Diagnostic Catheterization May Be Safely Avoided
Section snippets
Methods
From April 2005 to February 2006, all patients referred for CTA at a single-specialty ambulatory cardiology practice were prospectively entered into a database based on a predefined comprehensive data-collection tool after informed consent was obtained. As 1 of the indications for CTA, any of the 25 cardiologists in the group would refer symptomatic patients in the absence of contraindications if they had a previous abnormal MPSI result based on the criteria7, 8, 9 of (1) stress-induced
Results
Of 2,132 patients who underwent MPSI during the study period, 421 (20%) were referred for CTA because of being classified as intermediate risk after MPSI. Baseline characteristics, previous symptoms, and type and results of previous stress testing are listed in Table 1.
Average heart rate achieved before the procedure was 56 ± 13 beats/min. Adequate diagnostic quality was achieved in 99% of cases, with all 17 AHA segments available in 92%. Most uninterpretable segments were distal or in small
Discussion
This study showed that CTA could significantly impact on the clinical evaluation of symptomatic patients classified at intermediate risk for cardiovascular events after MPSI. Recent reports emphasized the strengths of the complementary information provided by combined MPSI-CTA evaluation; however, to our knowledge, this was the first study to show its application in clinical practice.12
The goal of assessing patients with known or suspected CAD was to identify those in whom subsequent
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This work was supported by Chicagoland Heart Foundation, Hinsdale, Illinois.