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      Coronary Computed Tomography Angiography Improving Outcomes in Patients with Chest Pain

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose of Review

          To provide an overview of recent studies of coronary computed tomography angiography (CCTA) and how it has helped to improve clinical outcomes for patients presenting with chest pain.

          Recent Findings

          Randomised controlled trials have uniformly demonstrated that the use of CCTA is associated with improvements in patient diagnosis, management and treatments as well as the avoidance of unnecessary invasive coronary angiography. These changes have been associated with consistent reductions in long-term rates of fatal or non-fatal myocardial infarction.

          Summary

          Major beneficial effects in clinical management and patient outcomes are seen with the use of coronary computed tomography angiography. CCTA might be considered to be the first test of choice for the investigation of coronary heart disease.

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          Most cited references55

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          A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010

          Stephen S Lim, Theo Vos, Abraham D. Flaxman … (2012)
          The Lancet, 380(9859), 2224-2260
          Article 0 comments Cited 3839 times – based on 0 reviews     Review now
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            Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein.

            Paul Ridker, Eleanor Danielson, Francisco A.H. Fonseca … (2008)
            Increased levels of the inflammatory biomarker high-sensitivity C-reactive protein predict cardiovascular events. Since statins lower levels of high-sensitivity C-reactive protein as well as cholesterol, we hypothesized that people with elevated high-sensitivity C-reactive protein levels but without hyperlipidemia might benefit from statin treatment. We randomly assigned 17,802 apparently healthy men and women with low-density lipoprotein (LDL) cholesterol levels of less than 130 mg per deciliter (3.4 mmol per liter) and high-sensitivity C-reactive protein levels of 2.0 mg per liter or higher to rosuvastatin, 20 mg daily, or placebo and followed them for the occurrence of the combined primary end point of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from cardiovascular causes. The trial was stopped after a median follow-up of 1.9 years (maximum, 5.0). Rosuvastatin reduced LDL cholesterol levels by 50% and high-sensitivity C-reactive protein levels by 37%. The rates of the primary end point were 0.77 and 1.36 per 100 person-years of follow-up in the rosuvastatin and placebo groups, respectively (hazard ratio for rosuvastatin, 0.56; 95% confidence interval [CI], 0.46 to 0.69; P<0.00001), with corresponding rates of 0.17 and 0.37 for myocardial infarction (hazard ratio, 0.46; 95% CI, 0.30 to 0.70; P=0.0002), 0.18 and 0.34 for stroke (hazard ratio, 0.52; 95% CI, 0.34 to 0.79; P=0.002), 0.41 and 0.77 for revascularization or unstable angina (hazard ratio, 0.53; 95% CI, 0.40 to 0.70; P<0.00001), 0.45 and 0.85 for the combined end point of myocardial infarction, stroke, or death from cardiovascular causes (hazard ratio, 0.53; 95% CI, 0.40 to 0.69; P<0.00001), and 1.00 and 1.25 for death from any cause (hazard ratio, 0.80; 95% CI, 0.67 to 0.97; P=0.02). Consistent effects were observed in all subgroups evaluated. The rosuvastatin group did not have a significant increase in myopathy or cancer but did have a higher incidence of physician-reported diabetes. In this trial of apparently healthy persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events. (ClinicalTrials.gov number, NCT00239681.) 2008 Massachusetts Medical Society
            Article 0 comments Cited 548 times – based on 0 reviews     Review now
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              2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology.

              Gilles Montalescot, Udo Sechtem, Stephan Achenbach … (2014)
              Article 0 comments Cited 449 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                David E. Newby
                Journal
                Journal ID (nlm-journal-id): 101484775
                Journal ID (nlm-ta): Curr Cardiovasc Imaging Rep
                Journal ID (iso-abbrev): Curr Cardiovasc Imaging Rep
                Title: Current cardiovascular imaging reports
                ISSN (Print): 1941-9066
                ISSN (Electronic): 1941-9074
                Publication date Nihms-submitted: 22 December 2020
                Publication date (Electronic): 22 March 2019
                Publication date PMC-release: 12 January 2021
                Volume: 12
                Electronic Location Identifier: 15
                Affiliations
                [1 ]British Heart Foundation, Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s Building, Edinburgh EH16 4SA, Scotland, UK
                Author notes
                Article
                Manuscript ID: EMS108843
                DOI: 10.1007/s12410-019-9492-6
                PMC ID: 7116579
                PubMed ID: 33442442
                SO-VID: a7d98880-8891-46fe-92e6-98ae16be2608
                License:

                This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Categories
                Subject: Article

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: computed tomography coronary angiography,coronary artery disease,exercise electrocardiography,stress echocardiography,myocardial perfusion imaging,cardiac magnetic resonance imaging
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: computed tomography coronary angiography, coronary artery disease, exercise electrocardiography, stress echocardiography, myocardial perfusion imaging, cardiac magnetic resonance imaging

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