Sunday, October 15, 2017

CT Angiography for Chest Pain

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Medscape - By Patrice Wendling - October 11, 2017
"HERSHEY, PA — A new meta-analysis shows that use of coronary computed tomography angiography (CTA) is associated with significantly fewer MIs than standard functional stress testing in patients with suspected CAD and acute or stable chest pain.
CTA, however, is also associated with significantly more downstream invasive coronary procedures, CAD diagnoses, and aspirin and statin prescriptions—all without an overall reduction in mortality or cardiac hospitalizations.
"If you look at the strength and robustness of the individual findings, what my coauthors and I can say with high certainty is that cardiac CT compared with functional testing will lead to a significant increase in downstream procedures, whether that's just catheterization or whether it's also revascularization, and we believe that a lot, if not all, of that excess is unnecessary," corresponding author Dr Andrew J Foy (Penn State College of Medicine, Hershey, PA), told | Medscape Cardiology.
The study, with senior author Dr Rita Redberg (University of California, San Francisco), was published October 3, 2017 in JAMA Internal Medicine."