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Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease

by Udelson, James E , Hoffmann, Udo , Lee, Kerry L , Malhotra, Vinay , Velazquez, Eric J , Dolor, Rowena J , Khan, Muhammad Akram , Picard, Michael H , Al-Khalidi, Hussein R , Mark, Daniel B , Huang, Megan , Kosinski, Andrzej S , Cole, Jason , Fordyce, Christopher B , Yow, Eric , Cooper, Lawton S , Douglas, Pamela S , Krucoff, Mitchell W , Patel, Manesh R , Cavanaugh, Brendan

in Aged / Angina / Angina, Unstable - epidemiology / Angiography / Cardiac Catheterization / Cardiovascular disease / Catheterization / Chest Pain - etiology / Clinical trials / Computed tomography / Coronary Angiography - adverse effects / Coronary Angiography - methods / Coronary artery / Coronary Artery Disease - diagnosis / Diagnostic tests / Dyspnea / Echocardiography / Echocardiography, Stress - adverse effects / EKG / Electrocardiography / Exercise Test / Female / Follow-Up Studies / Heart diseases / Humans / Kaplan-Meier Estimate / Male / Medical diagnosis / Middle Aged / Mortality / Myocardial infarction / Myocardial Infarction - epidemiology / Pain / Respiration / Tomography, X-Ray Computed

2015

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2015

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2015

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Journal Article

Outcomes of Anatomical versus Functional Testing for Coronary Artery Disease

Udelson, James E,

Hoffmann, Udo,

Lee, Kerry L,

Malhotra, Vinay,

Velazquez, Eric J,

Dolor, Rowena J,

Khan, Muhammad Akram,

Picard, Michael H,

Al-Khalidi, Hussein R,

Mark, Daniel B,

Huang, Megan,

Kosinski, Andrzej S,

Cole, Jason,

Fordyce, Christopher B,

Yow, Eric,

Cooper, Lawton S,

Douglas, Pamela S,

Krucoff, Mitchell W,

Patel, Manesh R,

Cavanaugh, Brendan

2015

Overview

In a trial involving 10,003 patients with suspected coronary artery disease, clinical outcomes at 2 years were not improved with an initial strategy of CT angiography, as compared with functional testing (exercise ECG, nuclear stress testing, or stress echocardiography). New-onset, stable chest pain is a common clinical problem that results in approximately 4 million stress tests annually in the United States in ambulatory patients without diagnosed heart disease. 1 Despite advances in cardiac testing, there is scant information on health-related outcomes and little consensus about which noninvasive test is preferable. 2 – 4 As a result, current patterns of care have been questioned, including the testing of very-low-risk populations 5 and the catheterization of patients who do not have obstructive coronary artery disease (CAD). 6 – 8 The development of coronary computed tomographic angiography (CTA) and its application in this context has the potential to . . .

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Publisher

Massachusetts Medical Society

Subject

Aged

/ Angina

/ Angina, Unstable - epidemiology

/ Angiography

/ Cardiac Catheterization

/ Cardiovascular disease

/ Catheterization