CCTA Associated With Decreased MI Incidence in Suspected Coronary Artery Disease
Patients undergoing CCTA were also more likely to receive a diagnosis of new CAD and have started aspirin or statin therapy.
Healthday News — For patients with suspected coronary artery disease (CAD), coronary computed tomography angiography (CCTA) is associated with reduced incidence of myocardial infarction but no reduction in death or cardiac hospitalization vs functional stress testing, according to a review published in JAMA Internal Medicine.
Andrew J. Foy, MD, from the Penn State College of Medicine in Hershey, and colleagues conducted a systematic review of 13 randomized trials involving patients with suspected CAD. Overall, 10,315 patients were in the CCTA arm and 9777 in the functional stress testing arm, with a mean follow-up of 18 months.
The researchers found that no statistically significant differences were seen between CCTA and functional stress testing in death (1% vs 1.1%; risk ratio [RR], 0.93; 95% confidence interval [CI], 0.71 to 1.21) or cardiac hospitalization (2.7% vs 2.7%; RR,0.98; 95% CI, 0.79 to 1.21). CCTA correlated with reduced myocardial infarction incidence (0.7% vs 1.1%; RR, 0.71; 95% CI, 0.53 to 0.96). It also correlated with elevated likelihood of undergoing invasive coronary angiography (11.7% vs 9.1%; RR, 1.33; 95% CI, 1.12 to 1.59) and revascularization (7.2% vs 4.5%; RR, 1.86; 95% CI, 1.43 to 2.43). Patients undergoing CCTA were also more likely to receive a diagnosis of new CAD and have started aspirin or statin therapy.
"CCTA is not associated with a reduction in mortality or cardiac hospitalizations," the authors write.
Foy AJ, Dhruva SS, Peterson B, et al. Coronary computed tomography angiography vs functional stress testing for patients with suspected coronary artery disease [published online October 2, 2017]. JAMA Intern Med. doi: 10.1001/jamainternmed.2017.4772