Integration of CTA in the Diagnostic Workup of New Onset Chest Pain in Clinical Practice

BioMed Research International
Nazario CarrabbaRenato Valenti

Abstract

Recently, NICE guidelines recommend the use of computed tomographic angiography (CTA) as the first line of investigation for new onset chest pain. We sought to evaluate the impact of the integration of CTA in the diagnostic workup, as either a first- or second-line of investigation, in the clinical practice for patients presenting with new onset chest pain, with suspicion that it may be due to coronary artery disease (CAD). From 2014 to 2016, 208 outpatients (mean age 63.8 ± 12.7, 37% female) with an unknown CAD diagnosis were evaluated. About half (n=106, 51%) received usual testing care plus CTA as a second-line investigation (group A), while the other half (n=102, 49%) received CTA as a first-line investigation (group B). Care decisions and test interpretations were made by the attending physician. Obstructive CAD (O-CAD) was defined as >50% stenosis in the principal branch. As determined by CTA, the rates of CAD in group A vs. group B were the following (P=0.001): 31.1% vs. 27.4% for normal/minimal CAD; 42.5% vs. 63.7% for no O-CAD; and 26.4% vs. 8.8% with O-CAD. Based on a diagnostic result of no O-CAD, invasive angiography was cancelled in 42.6% (n=45) of group A patients, and additional functional tests were cancelled fo...Continue Reading

References

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Dec 12, 2018·BioMed Research International·Nazario CarrabbaRenato Valenti

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Citations

Jul 18, 2020·La Radiologia medica·Ernesto Di CesareAntonio Esposito
Oct 1, 2020·Journal of cardiology·Ann Christine Modaragamage DonaAmer Harky
Feb 25, 2021·BioMed Research International·Maria Concetta PastoreMatteo Cameli

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