How should CT coronary angiography be integrated into the management of patients with chest pain and how does this affect outcomes?

European Heart Journal. Quality of Care & Clinical Outcomes
Mhairi K Doris, David E Newby

Abstract

When examining the role of a diagnostic test in clinical practice, consideration must be placed not only on the accuracy of the result, but also its impact on patient care and outcomes. Proving a direct effect on outcomes may be difficult because the impact of the diagnostic test largely depends on the clinician's interpretation and consequent actions as well as the patient's response to changes in their diagnosis, investigations, and treatment. Recent major clinical trials of symptomatic patients with suspected coronary heart disease (CHD) have shown that computed tomography coronary angiography (CTCA) can markedly clarify the diagnosis and lead to major changes in patient investigation and management including the use of invasive angiography, preventative therapies, and coronary revascularization. Thus, when added to our existing clinical tools, such as exercise electrocardiography, CTCA represents a powerful method of identifying and excluding CHD. Furthermore, it can identify patients with prognostically relevant non-obstructive CHD and, with recent technological advances, will be able to assess the functional impact of anatomically detected coronary artery stenoses. Overall, the routine integration of CTCA into the investi...Continue Reading

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Citations

Feb 15, 2019·Arteriosclerosis, Thrombosis, and Vascular Biology·Reza HajhosseinyRené M Botnar
Mar 16, 2019·The International Journal of Cardiovascular Imaging·Wael AlJaroudiElie Chammas
Mar 23, 2020·JACC. Cardiovascular Imaging·Reza HajhosseinyRené M Botnar
Jan 12, 2022·European Heart Journal·Adam TimmisUNKNOWN Atlas Writing Group

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