Coronary heart disease CT
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The role of coronary computed tomographic angiography (CCTA) versus functional testing is not clear:
- The SCOT-HEART trial in 2015 did not find clear statistical evidence of benefit anlthought there was a trend towards less cardiac outcomes among patients who received CTA[1][2]
- The PROMISE trial in 2015 did not find benefit[2]
- A meta-analysis in 2018 that included the SCOT-HEART and PROMISE trials found not benefit[3]
- Subsequent publication of longer term follow-up of the SCOT-HEART trial found cardiac benefit[4]
CCTA may best benefit patients with intermediate risk[5].
References
- ↑ SCOT-HEART investigators (2015). "CT coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial". Lancet. 385 (9985): 2383–91. doi:10.1016/S0140-6736(15)60291-4. PMID 25788230.
- ↑ 2.0 2.1 Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B; et al. (2015). "Outcomes of anatomical versus functional testing for coronary artery disease". N Engl J Med. 372 (14): 1291–300. doi:10.1056/NEJMoa1415516. PMC 4473773. PMID 25773919. Review in: Evid Based Med. 2015 Aug;20(4):145 Review in: Ann Intern Med. 2015 Aug 18;163(4):JC11
- ↑ Siontis GC, Mavridis D, Greenwood JP, Coles B, Nikolakopoulou A, Jüni P; et al. (2018). "Outcomes of non-invasive diagnostic modalities for the detection of coronary artery disease: network meta-analysis of diagnostic randomised controlled trials". BMJ. 360: k504. doi:10.1136/bmj.k504. PMC 5820645. PMID 29467161.
- ↑ SCOT-HEART Investigators. Newby DE, Adamson PD, Berry C, Boon NA, Dweck MR; et al. (2018). "Coronary CT Angiography and 5-Year Risk of Myocardial Infarction". N Engl J Med. 379 (10): 924–933. doi:10.1056/NEJMoa1805971. PMID 30145934. Review in: Ann Intern Med. 2018 Dec 18;169(12):JC70
- ↑ Han D, Beecy A, Anchouche K, Gransar H, Dunham PC, Lee JH; et al. (2019). "Risk Reclassification With Coronary Computed Tomography Angiography-Visualized Nonobstructive Coronary Artery Disease According to 2018 American College of Cardiology/American Heart Association Cholesterol Guidelines (from the Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes : An International Multicenter Registry [CONFIRM])". Am J Cardiol. 124 (9): 1397–1405. doi:10.1016/j.amjcard.2019.07.045. PMID 31547994.