دورية أكاديمية
أعرض في EDS

Outcomes in patients with a first episode of chest pain undergoing early coronary CT imaging.

التفاصيل البيبلوغرافية
العنوان: Outcomes in patients with a first episode of chest pain undergoing early coronary CT imaging.
المؤلفون: Siegersma KR; Department of Cardiology, Amsterdam UMC VUMC Site, Amsterdam, The Netherlands.; Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Onland-Moret NC; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Appelman Y; Department of Cardiology, Amsterdam UMC VUMC Site, Amsterdam, The Netherlands., van der Harst P; Department of Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Tulevski II; Cardiology Centers of the Netherlands, Utrecht, The Netherlands., Somsen GA; Cardiology Centers of the Netherlands, Utrecht, The Netherlands., Narula J; Icahn School of Medicine at Mount Sinai, New York, New York, USA., den Ruijter HM; Laboratory of Experimental Cardiology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands., Hofstra L; Department of Cardiology, Amsterdam UMC VUMC Site, Amsterdam, The Netherlands leonard.hofstra@gmail.com.; Cardiology Centers of the Netherlands, Utrecht, The Netherlands.
المصدر: Heart (British Cardiac Society) [Heart] 2022 Aug 11; Vol. 108 (17), pp. 1361-1368. Date of Electronic Publication: 2022 Aug 11.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9602087 Publication Model: Electronic Cited Medium: Internet ISSN: 1468-201X (Electronic) Linking ISSN: 13556037 NLM ISO Abbreviation: Heart Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Pub. Group, c1996-
مواضيع طبية MeSH: Coronary Artery Disease*/complications , Coronary Artery Disease*/diagnostic imaging, Angina Pectoris/complications ; Angina Pectoris/diagnostic imaging ; Angina Pectoris/therapy ; Chest Pain/diagnosis ; Chest Pain/etiology ; Computed Tomography Angiography ; Coronary Angiography/methods ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Tomography, X-Ray Computed/methods
مستخلص: Objectives: To investigate the impact of a CT-first strategy on all-cause and cardiovascular mortality in patients presenting with chest pain in outpatient cardiology clinics.
Methods: Patients with a first presentation of suspected angina pectoris were identified and their data linked to the registrations of Statistics Netherlands for information on mortality. The linked database consisted of 33 068 patients. CT-first patients were defined as patients with a CT calcium score and coronary CT angiography, within 6 weeks after their initial visit. Propensity score matching (1:5) was used to match patients with and without a CT-first strategy. After matching, 12 545 patients were included of which 2308 CT-first patients and 10 237 patients that underwent usual care.
Results: Mean age was 57 years, 56.3% were women and median follow-up was 4.9 years. All-cause mortality was significantly lower in CT-first patients (n=43, 1.9%) compared with patients without CT (n=363, 3.5%) (HR: 0.51, 95% CI 0.37 to 0.70). Furthermore, CT-first patients were more likely to receive cardiovascular preventative and antianginal medication (aspirin: 44.9% vs 27.1%, statins: 48.7% vs 30.3%, beta-blockers: 37.8% vs 25.5%, in CT-first and without CT-first patients, respectively) and to undergo downstream diagnostics and interventions (coronary interventions: 8.5% vs 5.7%, coronary angiography: 16.2% vs 10.6% in CT-first and without CT-first patients, respectively).
Conclusions: In a real-world regular care database, a CT-first strategy in patients suspected of angina pectoris was associated with a lowering of all-cause mortality.
Competing Interests: Competing interests: LH, IIT and GAS are employed by Cardiology Centres of the Netherlands.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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فهرسة مساهمة: Keywords: computed tomography angiography; coronary artery disease; diagnostic imaging; electronic health records
تواريخ الأحداث: Date Created: 20211116 Date Completed: 20220815 Latest Revision: 20221113
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9380517
DOI: 10.1136/heartjnl-2021-319747
PMID: 34782405
قاعدة البيانات: MEDLINE
الوصف
تدمد:1468-201X
DOI:10.1136/heartjnl-2021-319747