CT coronary angiographic evaluation of suspected anginal chest pain
| Autor: | Alastair J Moss, David E. Newby |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Computed Tomography Angiography Coronary Artery Disease 030204 cardiovascular system & hematology Chest pain Appropriate use Coronary Angiography Angina Pectoris Coronary artery disease Angina 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Humans 030212 general & internal medicine Myocardial infarction Coronary revascularisation business.industry Reproducibility of Results medicine.disease Prognosis Coronary Vessels Invasive coronary angiography Clinical trial Practice Guidelines as Topic Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Heart (British Cardiac Society). 102(4) |
| ISSN: | 1468-201X |
| Popis: | Non-invasive imaging plays a critical role in the assessment of patients presenting with suspected angina chest pain. However, wide variations in practice across Europe and North America highlight the lack of consensus in selecting the appropriate first-line test for the investigation of coronary artery disease (CAD). CT coronary angiography (CTCA) has a high negative predictive value for excluding the presence of CAD. As such, it serves as a potential ‘gatekeeper’ to downstream testing by reducing the rate of inappropriate invasive coronary angiography. Two recent large multicentre randomised control trials have provided insights into whether CTCA can be incorporated into chest pain care pathways to improve risk stratification of CAD. They demonstrate that using CTCA enhances diagnostic certainty and improves the targeting of appropriate invasive investigations and therapeutic interventions. Importantly, reductions in cardiac death and non-fatal myocardial infarction appear to be attained through the more appropriate use of preventative therapy and coronary revascularisation when guided by CTCA. With this increasing portfolio of evidence, CTCA should be considered the non-invasive investigation of choice in the evaluation of patients with suspected angina pectoris due to coronary heart disease. Clinical trial number NCT01149590, post-results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|