PMID- 35735809
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230308
IS  - 2308-3425 (Electronic)
IS  - 2308-3425 (Linking)
VI  - 9
IP  - 6
DP  - 2022 Jun 4
TI  - Evaluation of the Appropriate Use of Coronary Computed Tomography Angiography: A 
      Retrospective, Single-Center Analysis.
LID - 10.3390/jcdd9060180 [doi]
LID - 180
AB  - Purpose: We assessed the application of appropriate use criteria of coronary 
      computed tomography angiography (CCTA) in comparison to invasive coronary 
      angiography results and revascularization rates in patients with coronary artery 
      disease (CAD). Methods: 1305 patients referred to invasive coronary angiography 
      (ICA) after CCTA were evaluated retrospectively. The primary indication for CCTA 
      was assessed according to the consensus for intermediate-risk (15-85% pre-test 
      probability) into appropriate (A), inappropriate (I), and uncertain while 
      referring to published guidelines. Patients' risk factors, angina, and heart 
      failure symptoms (Canadian Cardiovascular Society classification (CCSC), New York 
      Heart Association (NYHA); clinical data; and ICA results were gathered. Results: 
      Of 1305 patients referred to CCTA prior to ICA, 496 (38.0%) were appropriate, 766 
      (56.9%) inappropriate, and 43 (3.3%) uncertain. Of 766 patients with 
      inappropriate CCTA referrals, 370 (48.3%) were classified as "inappropriately 
      low" (<15% pre-test probability) and 396 (51.7%) as "inappropriately high" (>85%) 
      in regard to the recommended CCTA utilization. Sub-analysis of the adherence to 
      the appropriate use criteria did not differ between the source of the referring 
      physicians (intramural tertiary, private practice primary care, or external 
      secondary care hospitals). Obstructive CAD with subsequent revascularization 
      rates (total of 39.2%) did not differ significantly between the appropriate 
      (38.3%), inappropriate (41.0%), or uncertain (23.3%) groups (p = 0.068). 
      Conclusion: The total coronary revascularization rate after CCTA was 39.2% and 
      not different among low, intermediate, and pre-test probability groups. These 
      findings support the role of CCTA as an excellent gatekeeper in patients with 
      suspected obstructive CAD even beyond pre-test probability calculation models.
FAU - Birkl, Katharina
AU  - Birkl K
AD  - Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria.
FAU - Beyer, Christoph
AU  - Beyer C
AD  - Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria.
FAU - Plank, Fabian
AU  - Plank F
AD  - Department of Internal Medicine III-Cardiology and Angiology, Innsbruck Medical 
      University, 6020 Innsbruck, Austria.
FAU - Feuchtner, Gudrun Maria
AU  - Feuchtner GM
AUID- ORCID: 0000-0001-6755-4399
AD  - Department of Radiology, Innsbruck Medical University, 6020 Innsbruck, Austria.
FAU - Friedrich, Guy
AU  - Friedrich G
AUID- ORCID: 0000-0001-6052-2335
AD  - Department of Internal Medicine III-Cardiology and Angiology, Innsbruck Medical 
      University, 6020 Innsbruck, Austria.
LA  - eng
PT  - Journal Article
DEP - 20220604
PL  - Switzerland
TA  - J Cardiovasc Dev Dis
JT  - Journal of cardiovascular development and disease
JID - 101651414
PMC - PMC9225320
OTO - NOTNLM
OT  - appropriate use
OT  - coronary artery disease
OT  - coronary computed tomography angiography
OT  - invasive coronary angiography
OT  - percutaneous coronary intervention
COIS- The authors have no conflict of interest to disclose.
EDAT- 2022/06/24 06:00
MHDA- 2022/06/24 06:01
PMCR- 2022/06/04
CRDT- 2022/06/23 08:53
PHST- 2022/04/15 00:00 [received]
PHST- 2022/06/01 00:00 [revised]
PHST- 2022/06/02 00:00 [accepted]
PHST- 2022/06/23 08:53 [entrez]
PHST- 2022/06/24 06:00 [pubmed]
PHST- 2022/06/24 06:01 [medline]
PHST- 2022/06/04 00:00 [pmc-release]
AID - jcdd9060180 [pii]
AID - jcdd-09-00180 [pii]
AID - 10.3390/jcdd9060180 [doi]
PST - epublish
SO  - J Cardiovasc Dev Dis. 2022 Jun 4;9(6):180. doi: 10.3390/jcdd9060180.