Reclassification of 83 percent of patients with intermediate pretest probability of CAD
FRIDAY, June 12, 2015 (HealthDay News) — For most patients with chest pain and low to intermediate pretest probability (PTP) of obstructive coronary artery disease (CAD), coronary computed tomography angiography (CCTA) results in reclassification, according to a study published in the July 1 issue of The American Journal of Cardiology.
Michiel J. Bom, M.D., from the Medical Center Alkmaar in the Netherlands, and colleagues examined reclassification by CCTA and implications of CCTA results on management. Data were included from 1,560 patients with chest pain without a history of CAD and with low or intermediate PTP of CAD who were referred for CCTA.
The researchers found that CCTA identified obstructive CAD in 7, 15, and 23 percent of cases in patients with low, low-intermediate, and high-intermediate PTP, respectively. Of patients with intermediate PTP of CAD, 83 percent showed no obstructive CAD on CCTA and were reclassified. Forty-four percent of patients had management changes after CCTA: 41 percent had alteration of medication and 9 percent were referred for invasive coronary angiography. Statin treatment was initiated and stopped in 28 and 5 percent, respectively, while aspirin was initiated and stopped in 12 and 9 percent, respectively.
“Our study shows that CCTA is a noninvasive imaging tool with an important impact on the daily clinical practice of patients with chronic chest pain and low-to-intermediate PTP, with reclassification in most patients and alteration in management in nearly half of the patients,” the authors write.
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