Real-World Trends in the Use of Coronary Computed Tomography Angiography for Stable Coronary Artery Disease
Journal of the Society for Cardiovascular Angiography & Interventions
Coronary computed tomography angiography (CCTA) may be sufficient to determine the need for revascularization in patients with stable coronary artery disease (CAD). We describe the clinical characteristics of patients with stable CAD who underwent both CCTA and diagnostic invasive coronary angiography (CA) and compare them to those who directly underwent invasive
Patients who underwent CA at our institution between January 2017 and December 2018 were retrospectively included. We collected baseline demographics, medical history, and prior ischemic work-up. Patients were divided into groups based on whether they had CCTA done within 12 months prior to CA.
We identified 5180 patients who underwent diagnostic CA, 582 (11.2%) of which had CCTA within the previous 12 months. There were no significant differences between patients who had CCTA done prior to diagnostic CA and those who had CA directly with respect to mean age, BMI, and GFR. CCTA was performed in several patients with morbid obesity, contrast allergy, chronic kidney disease, and history of coronary interventions (Table 1).
Patients with stable CAD directly undergo invasive diagnostic CA in almost 90% of cases. CCTA for stable CAD remains underutilized. Factors influencing the decision to go directly to diagnostic CA are BMI, GFR, history of coronary interventions and strong clinical suspicion for hemodynamically significant CAD (positive stress test and elevated troponin).
Donisan T, Balanescu DV, Mertens A, Allen O, Willner S, Mando R, et al. [Safian RD]. Real-world trends in the use of coronary computed tomography angiography for stable coronary artery disease. J Soc Cardiovasc Angiogr Interv. 2022 May-Jun;1(3 Suppl):100209. doi:10.1016/j.jscai.2022.100209.