Coronary computed tomography angiography (CCTA) in patients with suspected stable coronary artery disease (CAD): diagnostic impact and clinical consequences in the German Cardiac CT Registry depending on stress test results
Coronary computed tomography angiography (CCTA) in patients with suspected stable coronary artery disease (CAD): diagnostic impact and clinical consequences in the German Cardiac CT Registry depending on stress test results
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DOI：
10.1007/s10554-018-1504-0
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发表时间：
2018-11
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通讯作者：
S. Barth;M. Marwan;J. Hausleiter;W. Moshage;G. Korosoglou;A. Leber;A. Schmermund;H. Gohlke;O. Bruder;T. Dill;S. Schröder;S. Kerber;K. Hamm;F. Gietzen;S. Schneider;J. Senges;S. Achenbach
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作者：
S. Barth;M. Marwan;J. Hausleiter;W. Moshage;G. Korosoglou;A. Leber;A. Schmermund;H. Gohlke;O. Bruder;T. Dill;S. Schröder;S. Kerber;K. Hamm;F. Gietzen;S. Schneider;J. Senges;S. Achenbach
根据日常实践中的负荷试验结果，评价临床使用冠状动脉计算机断层扫描血管造影术（CCTA）对疑似稳定型冠状动脉疾病（CAD）患者的诊断影响及其在患者管理日常实践中的后果。2009年至2014年期间，在德国心脏计算机断层扫描（CT）登记研究的1352例既往接受过负荷试验的患者中，对疑似稳定型CAD的冠状动脉进行了CCTA可视化。根据负荷试验结果将患者分为三组：不确定组（n = 178，13.2%），负荷试验中缺血组（n = 372，27.5%）和负荷试验中无缺血组（n = 802，59.3%）。首选试验是负荷心电图（ECG），与缺血患者相比，负荷试验中无缺血患者更常进行ECG（96.3% vs 93.0%，p = 0.015）。与结果不确定的患者相比，负荷试验中提示缺血的患者中检出的阻塞性CAD的发生率较低（14.1% vs. 21.1%，p = 0.037）。在负荷试验中，有和无缺血的患者中梗阻性CAD的发生率无差异（14.1% vs. 15.8%，p = 0.440）。CCTA是排除阻塞性CAD的可靠、非侵入性选择，无论负荷试验结果如何。
To evaluate diagnostic impact of clinical use of coronary computed tomography angiography (CCTA) in patients with suspected stable coronary artery disease (CAD) and its consequences in daily practice for patient management, depending on stress test results in daily practice. Between 2009 and 2014 of a total population of 1352 patients of the German Cardiac Computed Tomography (CT) Registry who had previously undergone stress tests, CCTA visualizations were carried out on the coronary arteries with suspected stable CAD. Patients were divided into three groups according to stress test results: Group 1 with inconclusive (n = 178, 13.2%), Group 2withischemia in stress test (n = 372, 27.5%) and Group 3withoutischemia in stress test (n = 802, 59.3%). The test of preference was the stress electrocardiogram (ECG), which was performed more frequently in patients without ischemia in stress test as compared to those with ischemia (96.3% vs. 93.0%, p = 0.015). The incidence of detected obstructive CAD was lower in patients with suggested ischemia in stress test as compared to patients with inconclusive results (14.1% vs. 21.1%, p = 0.037). There was no difference in the incidence of an obstructive CAD in patients with and without ischemia in stress test (14.1% vs. 15.8%, p = 0.440). CCTA is a reliable, non-invasive option for ruling-out obstructive CAD irrespective of the stress test result.