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Published on: January 28, 2020
Coronary computed tomography angiography without significant stenosis predicts favourable three-year prognosis
Jeppe Maagaard Kristiansen1, Tomas Zaremba, Martin Berg Johansen
1Kardiologisk Afdeling, Aalborg Universitetshospital, Hobrovej 18-22, 9000 Aalborg, Denmark. jeppe_m_kristiansen@hotmail.com.
Insights
Patients suspected of coronary artery disease (CAD) who were discharged after coronary computed tomography angiography (CCTA) without further treatment showed a favorable cardiovascular prognosis with low mortality and few events.
Area of Science:
- Cardiology
- Radiology
- Public Health
Background:
- Coronary artery disease (CAD) diagnosis often involves advanced imaging.
- Coronary computed tomography angiography (CCTA) is a key diagnostic tool.
- Assessing outcomes for patients discharged after CCTA is crucial for clinical decision-making.
Purpose of the Study:
- To evaluate the incidence of death and cardiovascular events in patients suspected of CAD.
- To determine the rate of non-scheduled imaging following CCTA in outpatient settings.
- To assess the prognosis of patients discharged without immediate need for further examination or treatment.
Main Methods:
- Retrospective cohort study design.
- Inclusion of patients discharged from an outpatient clinic after CCTA (2009-2010).
- Follow-up utilizing nationwide Danish health registers.
Main Results:
- 683 patients were discharged without need for further examination.
- Low all-cause mortality (3.7 per 1,000 person-years) observed over 37 months.
- One acute myocardial infarction, no cardiovascular deaths, and 5.0% underwent later non-scheduled imaging.
Conclusions:
- Patients with suspected CAD discharged after CCTA without further intervention demonstrate a favorable cardiovascular prognosis.
- CCTA can safely identify patients with low risk of adverse cardiovascular outcomes.
- This supports the role of CCTA in guiding outpatient management of suspected CAD.
Introduction:
The objective of this study was to evaluate the incidence of death, cardiovascular events and the use of later non-scheduled imaging for coronary artery disease (CAD) in patients suspected for CAD and discharged without a need for further examination or treatment from an outpatient clinic following coronary computed tomography angiography (CCTA).
Material And Methods:
This was a retrospective cohort study among patients discharged from an outpatient clinic after CCTA at our institution during 2009 and 2010. Follow-up was performed using nationwide Danish registers.
Results:
A total of 683 (68.2%) out of 1001 patients were discharged from the outpatient clinic after CCTA with no need for further examination. These patients were included in our study. After a median follow-up of 37 months, a low all-cause mortality of 3.7 per 1,000 person-years was found. There was only one case of acute myocardial infarction and no cases of death related to cardiovascular disease. A total of 5.0% of the patients later underwent non-scheduled imaging, predominantly invasive coronary angiography. No patients had revascularisation performed during the study period.
Conclusion:
Patients with suspected CAD discharged after CCTA with no need for further examination have a favourable cardiovascular prognosis.
Funding:
Not relevant.
Trial Registration:
Not relevant.
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