Evaluation of the guideline-adherence of coronary angiography in patients with suspected chronic coronary syndrome - Results from the German prospective multicentre ENLIGHT-KHK project.

Autor:	Wein B; Elisabeth-Hospital, Contilia Heart and Vascular Centre, Essen, Germany.; Cardiology, Faculty of Medicine, University of Augsburg, Germany., Seleznova Y; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Germany., Mueller D; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Germany., Naumann M; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Germany., Loeser S; AOK Rheinland-Hamburg, Dusseldorf, Germany., Artmann J; Institute for Health Economics and Clinical Epidemiology, University of Cologne, Germany., Fritz T; AOK NORDWEST, Dortmund, Germany., Steffen M; Elisabeth-Hospital, Contilia Heart and Vascular Centre, Essen, Germany., Windhoevel U; CERC Deutschland GmbH, Essen, Germany., Haude M; Rheinlandklinikum Neuss, Germany., Vom Dahl J; Mariahilf Hospital, Moenchengladbach, Germany., Schaefer U; Heart and Vascular Centre, Bad Bevensen, Germany., Montenbruck M; Marien-Hospital, Hamburg, Germany., Zarse M; Medical Department III, Maerkische Kliniken, Luedenscheid, Germany., Jegodka R; Elisabeth Hospital, Recklinghausen, Germany., Dill T; Sana Hospital Benrath, Medical Department, Dusseldorf, Germany., Guelker JE; Petrus Hospital, Department of Cardiology and Rhythmology, Wuppertal, Germany.; University Witten/Herdecke, Faculty of Health, Witten, Germany., Boese D; Hochsauerland Hospital, Department of Cardiology, Arnsberg, Germany., Bruder O; Elisabeth-Hospital, Contilia Heart and Vascular Centre, Essen, Germany.; Ruhr University Bochum, Germany.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2023 Apr 08; Vol. 46, pp. 101203. Date of Electronic Publication: 2023 Apr 08 (Print Publication: 2023).
DOI:	10.1016/j.ijcha.2023.101203
Abstrakt:	Background: With 900'000 coronary angiographies (CA) per year, Germany has the highest annual per capita volume in Europe. Until now there are no prospective clinical data on the degree of guideline-adherence in the use of CA in patients with suspected chronic coronary syndrome (CCS) in Germany. Methods: Between January 2019 and August 2021, 458 patients with suspected CCS were recruited in nine German centres. Guideline-adherence was evaluated according to the current European Society of Cardiology and German guidelines. Pre-test probability (PTP) for CAD was determined using age, gender, and a standardized patient questionnaire to identify symptoms. Data on the diagnostic work-up were obtained from health records. Results: Patients were in mean 66.6 years old, male in 57.3 %, had known CAD in 48.4 % and presented with typical, atypical, non-anginal chest pain or dyspnoea in 35.7 %, 41.3 %, 23.0 % and 25.4 %, respectively. PTP according to the European guidelines was in mean 24.2 % (11.9 %-36.5 % 95 % CI). 20.9 % of the patients received guideline-recommended preceding non-invasive image guided testing. The use of CA was adherent to the European and German guideline recommendations in 20.4 % and 25.4 %, respectively. In multivariate-analysis, arterial hypertension and prior revascularization were predictors of guideline non-adherence. Conclusion: These are the first prospective clinical data which demonstrated an overall low degree of guideline-adherence in the use of CA in patients with suspected CCS in the German health care setting. To improve adherence rates, the availability of and access to non-invasive image guided testing needs to be strengthened. (German Clinical Trials Registry DRKS00015638 - Registration Date: 19.02.2019). Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Author(s).)
Databáze:	MEDLINE
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