Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Value of Myocardial Perfusion Assessment With Coronary Computed Tomography Angiography in Patients With Recent Acute-Onset Chest Pain

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Post-Systolic Shortening by Speckle Tracking Echocardiography Predicts Cardiac Events in Type 2 Diabetes

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Utility of Multimodality Intravascular Imaging and the Local Hemodynamic Forces to Predict Atherosclerotic Disease Progression

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Vascular Positron Emission Tomography and Restenosis in Symptomatic Peripheral Arterial Disease: A Prospective Clinical Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Incidence of acute myocardial infarction-related cardiogenic shock during corona virus disease 19 (COVID-19) pandemic

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Imidazole propionate is increased in diabetes and associated with dietary patterns and altered microbial ecology

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Hypertension, cardiovascular disease and cause of death in Danish living kidney donors: matched cohort study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Cardiac chamber volumes and left ventricular mass in people living with HIV and matched uninfected controls

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Catheter ablation and mortality, stroke and heart failure readmission with atrial fibrillation

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

OBJECTIVES: The authors sought to perform a randomized controlled trial to evaluate the clinical efficacy of combined examination with coronary computed tomography angiography (CTA) and computed tomography perfusion imaging (CTP) compared to coronary CTA alone.

BACKGROUND: Stress myocardial CTP may increase diagnostic specificity when added to coronary CTA in patients suspected of having ischemic heart disease.

METHODS: Patients recently hospitalized for acute-onset chest pain, in whom acute coronary syndrome had been ruled out by normal electrocardiograms, normal troponin levels, and relief of symptoms, and who had a clinical indication for outpatient noninvasive testing, were screened for inclusion in the CATCH-2 (CArdiac cT in the treatment of acute CHest pain 2) trial (NCT02014311). Patients were randomized 1:1 to examination with coronary CTA or coronary CTA+CTP. The primary endpoint was the frequency of coronary revascularization among patients referred for invasive coronary angiography (ICA) based on index computed tomography evaluation. Secondary endpoints were invasive procedural complications at index-related ICA, post-index cardiac death, hospital admittance because of recurrence of chest pain, unstable angina pectoris, or acute myocardial infarction, ICA, and revascularization.

RESULTS: Among 300 patients allocated to the coronary CTA+CTP group, 41 (14%) were referred for ICA compared with 89 (30%) allocated to coronary CTA (p < 0.0001). The primary endpoint occurred in 50% of coronary CTA+CTP patients versus 48% of invasively examined patients (p = 0.85). The total number of revascularizations was significantly lower in the coronary CTA+CTP group compared to the coronary CTA group (n = 20 [7%] vs. n = 42 [14%]; p = 0.0045). At median follow-up of 1.5 years, the occurrence of secondary endpoints was similar in the 2 groups.

CONCLUSIONS: A post-discharge diagnostic strategy of coronary CTA+CTP safely reduces the need for invasive examination and treatment in patients suspected of having ischemic heart disease. (CArdiac cT in the treatment of acute CHest pain 2-Myocardial CT Perfusion [CATCH2]; NCT02014311).

OriginalsprogEngelsk
TidsskriftJACC. Cardiovascular imaging
Vol/bind11
Udgave nummer11
Sider (fra-til)1611-1621
ISSN1936-878X
DOI
StatusUdgivet - 2018

ID: 52188986