POEMs

CT Coronary Angiography in Patients with Suspected CAD: No Short-Term Benefit, Increased Rate of Invasive Angiography

 


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Am Fam Physician. 2015 Nov 15;92(10):928.

Clinical Question

What value does computed tomographic (CT) coronary angiography have for patients with suspected coronary artery disease (CAD)?

Bottom Line

For patients with suspected stable CAD, adding CT coronary angiography had no short-term effect on patient symptoms or hospitalizations but increased the number of coronary angiograms. Additionally, more patients who had CT coronary angiography underwent preventive treatment and anti-anginal treatment. (Level of Evidence = 2b)

Synopsis

These investigators recruited 4,100 patients with suspected stable angina who were referred by their primary care physicians to 12 Scottish cardiology chest pain clinics. Each of the patients underwent a standardized assessment and were randomized to receive standard care or standard care plus CT coronary angiography. The electrocardiogram result was normal in more than 80% of the patients in each group. The cardiologist performed a stress test in 85% of the patients, and nearly two-thirds in each group were

POEMs (patient-oriented evidence that matters) are provided by EssentialEvidence Plus, a point-of-care clinical decision support system published by Wiley-Blackwell. For more information, please see http://www.essentialevidenceplus.com. Copyright Wiley-Blackwell. Used with permission.

For definitions of levels of evidence used in POEMs, see http://www.essentialevidenceplus.com/product/ebm_loe.cfm?show=oxford.

To subscribe to a free podcast of these and other POEMs that appear in AFP,search in iTunes for “POEM of the Week” or go to http://goo.gl/3niWXb.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of POEMs published in AFP is available at http://www.aafp.org/afp/poems.



 

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