Redefining CAV surveillance strategies: Benefits of CCTA vs. ICA.

Autor: Pergola V; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Pradegan N; Cardiac Surgery Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy. Electronic address: nicola.pradegan@gmail.com., Cozza E; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Cozac DA; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy; Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures, Romania., Cao I; Cardiac Surgery Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Tessari C; Cardiac Surgery Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Savo MT; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Toscano G; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Angelini A; Cardiovascular Pathology, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Tarzia V; Cardiac Surgery Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Tarantini G; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Tona F; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., De Conti G; Radiology Unit, Azienda Ospedale-Università Padova, 35128, Padova, Italy., Iliceto S; Cardiology Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Gerosa G; Cardiac Surgery Unit, Cardio-thoraco-vascular and Public Health Department, Padova University Hospital, Padova, Italy., Motta R; Department of Cardiac, Thoracic, Vascular Sciences and Public Health-DCTV, University of Padova, 35128, Padova, Italy.
Jazyk: angličtina
Zdroj: Journal of cardiovascular computed tomography [J Cardiovasc Comput Tomogr] 2024 Jul 20. Date of Electronic Publication: 2024 Jul 20.
DOI: 10.1016/j.jcct.2024.07.004
Abstrakt: Background: Cardiac allograft vasculopathy (CAV) assessment post-heart transplantation (HT) typically relies on invasive coronary angiography (ICA). However, cardiac computed tomography angiography (CCTA) is emerging as a promising alternative due to its potential benefits in economic, safety, and logistical aspects. This study aimed to evaluate the impact of a CCTA program on these aspects in CAV surveillance post-HT.
Methods: A retrospective single-center study was conducted between March 2021 and February 2023, involving HT patients who underwent either CCTA or ICA.
Results: Among 260 patients undergoing CAV surveillance, 115 (44.2%) patients underwent CCTA, and 145 (55.8%) patients underwent ICA. The CCTA group showed incurred lower overall costs (p ​< ​0.0001) and shorter hospitalization times (p ​< ​0.0001) compared to the ICA group. In terms of safety, CCTA surveillance required significantly lower contrast volumes (p ​< ​0.0001) and lower effective doses (p ​= ​0.03).
Conclusion: CCTA emerges as a safe and cost-effective non-invasive alternative for CAV surveillance post-HT, outperforming ICA in terms of safety, logistical aspects, and economic burden.
Competing Interests: Declaration of competing interest All authors declare that they have no conflicts of interest.
(Copyright © 2024. Published by Elsevier Inc.)
Databáze: MEDLINE
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