According to a new study published in the New England Journal of Medicine, Cardiac Computed Tomography (CT) can potentially provide a safer alternative to coronary angiography for assessing patients who suffer from stable chest pain or have undiagnosed Coronary Artery Disease (CAD).
Researchers used a randomized trial to conclude that more than 3,500 patients with stable chest pain in a randomized trial had a lower risk of major procedure-related complications with the use of CT. In contrast, initial cardiac CT and coronary angiography had similar cardiovascular risks.
Marc Dewey, MD, head of the Department of Radiology on Campus Charite Mitte, said, “The trial confirmed that the CT-based examination is safe in patients with stable chest pain and suspected coronary artery disease. Among the patients referred for cardiac catheterization and included in this trial, the risk of major cardiovascular events was found to be similar in both the CT and catheterization groups, occurring in 2.1% and 3.0% of patients, respectively. The incidence of major, procedure-related complications was found to be lower in patients managed with an initial CT strategy.”
The study was conducted between October 3, 2015, to April 12, 2019, by 26 European medical centers and involved 3,667 patients who were randomized in a 1:1 ratio to undergo CT or invasive coronary angiography.
Patients eligible for the study were required to be over 30 years old and referred due to stable chest pain with a high probability of obstructive CAD.
The study’s primary outcome focus was on major adverse cardiovascular events, some of which include cardiovascular death, nonfatal MI, or nonfatal stroke. Secondary procedure-related complications that took place either during or within the first 48 hours after CT invasive coronary angiography were also of interest.
A total of 90 major adverse cardiovascular events occurred among the study participants during the follow-up period.
Henryk Dreger, Deputy Head of Charite’s Department of Cardiology and Angiology said, “Now that it has been standardized and quality tested as part of the trial, this method could be made more widely available as part of the routine clinical care of people with intermediate CAD risk.”
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