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Diagnostic Accuracy and Impact of Computed Tomographic Coronary Angiography on Utilization of Invasive Coronary Angiography

Diagnostic Accuracy and Impact of Computed Tomographic Coronary Angiography on Utilization of... Diagnostic Accuracy and Impact of Computed Tomographic Coronary Angiography on Utilization of Invasive Coronary Angiography Benjamin J.W. Chow, MD, FRCPC; Arun Abraham, MBBS, FRACP; George A. Wells, PhD; Li Chen, MSc; Terrence D. Ruddy, MD, FRCPC; Yeung Yam, BSc; Nayia Govas; Phoebe Diane Galbraith, BN, MSc; Carole Dennie, MD, FRCPC; Rob S. Beanlands, MD, FRCPC Background—Computed tomographic coronary angiography (CTA), given its high negative predictive value, is a potential gatekeeper for invasive coronary angiography (ICA). Before CTA can be further accepted into clinical practice, its impact on healthcare resources needs to be better understood. We sought to determine the clinical impact of CTA on ICA referrals, CTA accuracy, and normalcy rate. Methods and Results—To determine the impact of CTA, consecutive patients (n7017) undergoing ICA before and after implementing a dedicated cardiac CT program were reviewed and compared with 3 other centers (n11 508). To determine CTA accuracy, we evaluated consecutive CTA patients who underwent ICA. For normalcy rate, we identified patients with a low pretest probability for obstructive coronary artery disease. With the implementation of a cardiac CT program, the frequency of normal ICA decreased from 31.5% (1114 of 3538 patients) to 26.8% (932 of 3479 patients) (P0.001). These http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Circulation: Cardiovascular Imaging Wolters Kluwer Health

Diagnostic Accuracy and Impact of Computed Tomographic Coronary Angiography on Utilization of Invasive Coronary Angiography

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References (26)

ISSN
1941-9651
eISSN
1942-0080
DOI
10.1161/CIRCIMAGING.108.792572
pmid
19808560
Publisher site
See Article on Publisher Site

Abstract

Diagnostic Accuracy and Impact of Computed Tomographic Coronary Angiography on Utilization of Invasive Coronary Angiography Benjamin J.W. Chow, MD, FRCPC; Arun Abraham, MBBS, FRACP; George A. Wells, PhD; Li Chen, MSc; Terrence D. Ruddy, MD, FRCPC; Yeung Yam, BSc; Nayia Govas; Phoebe Diane Galbraith, BN, MSc; Carole Dennie, MD, FRCPC; Rob S. Beanlands, MD, FRCPC Background—Computed tomographic coronary angiography (CTA), given its high negative predictive value, is a potential gatekeeper for invasive coronary angiography (ICA). Before CTA can be further accepted into clinical practice, its impact on healthcare resources needs to be better understood. We sought to determine the clinical impact of CTA on ICA referrals, CTA accuracy, and normalcy rate. Methods and Results—To determine the impact of CTA, consecutive patients (n7017) undergoing ICA before and after implementing a dedicated cardiac CT program were reviewed and compared with 3 other centers (n11 508). To determine CTA accuracy, we evaluated consecutive CTA patients who underwent ICA. For normalcy rate, we identified patients with a low pretest probability for obstructive coronary artery disease. With the implementation of a cardiac CT program, the frequency of normal ICA decreased from 31.5% (1114 of 3538 patients) to 26.8% (932 of 3479 patients) (P0.001). These

Journal

Circulation: Cardiovascular Imaging – Wolters Kluwer Health

Published: Jan 1, 2009

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