Diagnostic and prognostic benefits of computed tomography coronary angiography using the 2016 National Institute for Health and Care Excellence guidance within a randomised trial
| Autor: | Colin Berry, Nicholas L. Mills, Scott McLean, Michelle C. Williams, Tania Pawade, Elizabeth Clark, Edwin J R van Beek, Giles Roditi, John F. Forbes, David A. McAllister, Marcus Flather, Anoop S V Shah, Nicholas A. Boon, Marc R. Dweck, David E. Newby, Adam Timmis, Philip D Adamson, Amanda Hunter |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Chest Pain Pathology medicine.medical_specialty Computed Tomography Angiography MEDLINE Myocardial Infarction Cardiac computer tomographic (CT) imaging Nice Coronary Artery Disease 030204 cardiovascular system & hematology Chest pain Coronary Angiography Angina Coronary artery disease 03 medical and health sciences 0302 clinical medicine Post-hoc analysis medicine Journal Article Humans 030212 general & internal medicine Myocardial infarction Angina Stable computer.programming_language Aged business.industry Middle Aged medicine.disease Prognosis 3. Good health Stroke Scotland Relative risk Emergency medicine Practice Guidelines as Topic Female medicine.symptom Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business computer Follow-Up Studies |
| Zdroj: | Adamson, P D, Hunter, A, Williams, M C, Shah, A, McAllister, D A, Pawade, T A, Dweck, M R, Mills, N L, Berry, C, Boon, N A, Clark, E, Flather, M, Forbes, J, McLean, S, Roditi, G, van Beek, E J, Timmis, A D & Newby, D E 2017, ' Diagnostic and prognostic benefits of computed tomography coronary angiography using the 2016 National Institute for Health and Care Excellence guidance within a randomised trial ', Heart . https://doi.org/10.1136/heartjnl-2017-311508 Heart |
| ISSN: | 1355-6037 |
| Popis: | ObjectivesTo evaluate the diagnostic and prognostic benefits of CT coronary angiography (CTCA) using the 2016 National Institute for Health and Care Excellence (NICE) guidelines for the assessment of suspected stable angina.MethodsPost hoc analysis of the Scottish COmputed Tomography of the HEART (SCOT-HEART) trial of 4146 participants with suspected angina randomised to CTCA. Patients were dichotomised into NICE guideline-defined possible angina and non-anginal presentations. Primary (diagnostic) endpoint was diagnostic certainty of angina at 6 weeks and prognostic endpoint comprised fatal and non-fatal myocardial infarction (MI).ResultsIn 3770 eligible participants, CTCA increased diagnostic certainty more in those with possible angina (relative risk (RR) 2.22 (95% CI 1.91 to 2.60), pinteraction ConclusionsNICE-guided patient selection maximises the benefits of CTCA on diagnostic certainty, use of invasive coronary angiography and reductions in fatal and non-fatal myocardial infarction. Patients with non-anginal chest pain derive minimal benefit from CTCA and increase the rates of invasive investigation.Trial registration numberClinicalTrials.gov: NCT01149590;post results. |
| Databáze: | OpenAIRE |
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