Patient Preferences for Coronary CT Angiography with Stress Perfusion, SPECT, or Invasive Coronary Angiography

Area of Science:

• Cardiovascular Imaging
• Medical Diagnostics
• Patient-Reported Outcomes

Background:

• Patient preference is crucial for the adoption of diagnostic tests in clinical practice.
• Understanding patient preferences for noninvasive versus invasive tests for coronary artery disease is essential.

Purpose of the Study:

• To compare patient acceptance and preferences for noninvasive (coronary CT angiography, SPECT) and invasive (invasive coronary angiography) cardiac imaging.
• To assess patient preferences across different continents: North America, South America, Asia, and Europe.

Main Methods:

• Prospective, 16-center trial involving 381 participants undergoing coronary CT angiography with stress perfusion, SPECT, and invasive coronary angiography (ICA).
• Patient preferences were collected using a validated, multilingual questionnaire.
• Responses were analyzed using generalized linear mixed models on ordinal scales.

Main Results:

• Coronary CT angiography (CT) and SPECT were associated with significantly lower reported pain levels compared to ICA.
• Patients from Asia reported significantly higher pain levels and generally lower satisfaction with preparation across all tested modalities.
• Coronary CT angiography (CT) was the preferred test for 54% of all patients, followed by invasive coronary angiography (ICA) at 28% and SPECT at 18%.

Conclusions:

• Coronary CT angiography with stress perfusion is generally favored by patients for cardiac imaging due to lower reported pain.
• Significant regional differences exist in patient satisfaction, with Asian patients reporting lower satisfaction.
• These findings highlight the importance of considering patient preferences and regional variations in the implementation of cardiac imaging techniques.