-
J. Am. Coll. Cardiol. · Nov 2012
Multicenter StudyCoronary computed tomographic angiography as a gatekeeper to invasive diagnostic and surgical procedures: results from the multicenter CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter) registry.
- Leslee J Shaw, Jörg Hausleiter, Stephan Achenbach, Mouaz Al-Mallah, Daniel S Berman, Matthew J Budoff, Fillippo Cademartiri, Tracy Q Callister, Hyuk-Jae Chang, Yong-Jin Kim, Victor Y Cheng, Benjamin J W Chow, Ricardo C Cury, Augustin J Delago, Allison L Dunning, Gudrun M Feuchtner, Martin Hadamitzky, Ronald P Karlsberg, Philipp A Kaufmann, Jonathon Leipsic, Fay Y Lin, Kavitha M Chinnaiyan, Erica Maffei, Gilbert L Raff, Todd C Villines, Troy Labounty, Millie J Gomez, James K Min, and CONFIRM Registry Investigators.
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA. leslee.shaw@emory.edu
- J. Am. Coll. Cardiol. 2012 Nov 13; 60 (20): 2103-14.
ObjectivesThis study sought to examine patterns of follow-up invasive coronary angiography (ICA) and revascularization (REV) after coronary computed tomography angiography (CCTA).BackgroundCCTA is a noninvasive test that permits direct visualization of the extent and severity of coronary artery disease (CAD). Post-CCTA patterns of follow-up ICA and REV are incompletely defined.MethodsWe examined 15,207 intermediate likelihood patients from 8 sites in 6 countries; these patients were without known CAD, underwent CCTA, and were followed up for 2.3 ± 1.2 years for all-cause mortality. Coronary artery stenosis was judged as obstructive when ≥50% stenosis was present. A multivariable logistic regression was used to estimate ICA use. A Cox proportional hazards model was used to estimate all-cause mortality.ResultsDuring follow-up, ICA rates for patients with no CAD to mild CAD according to CCTA were low (2.5% and 8.3%), with similarly low rates of REV (0.3% and 2.5%). Most ICA procedures (79%) occurred ≤3 months of CCTA. Obstructive CAD was associated with higher rates of ICA and REV for 1-vessel (44.3% and 28.0%), 2-vessel (53.3% and 43.6%), and 3-vessel (69.4% and 66.8%) CAD, respectively. For patients with <50% stenosis, early ICA rates were elevated; over the entirety of follow-up, predictors of ICA were mild left main, mild proximal CAD, respectively, or higher coronary calcium scores. In patients with <50% stenosis, the relative hazard for death was 2.2 (p = 0.011) for ICA versus no ICA. Conversely, for patients with CAD, the relative hazard for death was 0.61 for ICA versus no ICA (p = 0.047).ConclusionsThese findings support the concept that CCTA may be used effectively as a gatekeeper to ICA.Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.