Coronary Computed Tomographic Angiography as a Gatekeeper to Invasive Diagnostic and Surgical Procedures
Coronary Computed Tomographic Angiography as a Gatekeeper to Invasive Diagnostic and Surgical Procedures
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DOI：
10.1016/j.jacc.2012.05.062
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发表时间：
2012-11-13
影响因子：
24
通讯作者：
Min, James K.
中科院分区：
文献类型：
--
作者：
Shaw, Leslee J.;Hausleiter, Joerg;Min, James K.
目的 本研究旨在探讨冠状动脉计算机断层扫描血管造影 (CCTA) 后后续有创冠状动脉造影 (ICA) 和血运重建 (REV) 的模式。 背景 CCTA 是一种无创测试，可以直接可视化冠状动脉疾病 (CAD) 的范围和严重程度。 CCTA 后随访 ICA 和 REV 模式尚未完全确定。 方法 我们检查了来自 6 个国家 8 个地点的 15,207 名中等可能性患者；这些患者没有已知的 CAD，接受了 CCTA，并随访了 2.3 +/- 1.2 年的全因死亡率。当狭窄≥50%时，冠状动脉狭窄被判定为阻塞性。使用多变量逻辑回归来估计 ICA 使用情况。使用 Cox 比例风险模型来估计全因死亡率。 结果 在随访期间，根据 CCTA，无 CAD 至轻度 CAD 患者的 ICA 率较低（2.5% 和 8.3%），REV 率也同样较低（0.3% 和 2.5%）。大多数 ICA 程序 (79%) 发生
Objectives This study sought to examine patterns of follow-up invasive coronary angiography (ICA) and revascularization (REV) after coronary computed tomography angiography (CCTA).Background CCTA is a noninvasive test that permits direct visualization of the extent and severity of coronary artery disease (CAD). Post-CCTA patterns of follow-up ICA and REV are incompletely defined.Methods We examined 15,207 intermediate likelihood patients from 8 sites in 6 countries; these patients were without known CAD, underwent CCTA, and were followed up for 2.3 +/- 1.2 years for all-cause mortality. Coronary artery stenosis was judged as obstructive when >= 50% stenosis was present. A multivariable logistic regression was used to estimate ICA use. A Cox proportional hazards model was used to estimate all-cause mortality.Results During follow-up, ICA rates for patients with no CAD to mild CAD according to CCTA were low (2.5% and 8.3%), with similarly low rates of REV (0.3% and 2.5%). Most ICA procedures (79%) occurred