BACKGROUND: The aims of this study are to analyze the risk profile and evaluate the appropriateness of patient referral to coronary CT angiography in a new MSCT laboratory in an academic medical center in a developing country. METHODS AND RESULTS: The study population consisted of 100 consecutive patients (mean age 53 ± 13 years, 83% males) who were referred to the new 64 slice MSCT laboratory at the American University of Beirut between July 2008 and July 2009. 52% of patients had chest pain and 48% were asymptomatic. By the 2006 ACCF criteria, only 8% of the referrals fitted the "Appropriate" criteria, 49% were "Inappropriate", and 43% were "Uncertain". The percentage of "Appropriate" indications increased from 8% by the 2006 criteria to 38% by the 2010 ACCF criteria. Framingham risk score (FRS) calculation showed a substantial percentage (46%) of patients to be at low risk, with 32% being at intermediate risk, and 22% at high risk. The prevalence of high calcium score (>400) (0% vs 22%, vs 27%, P < .001) and of obstructive CAD (4% vs 23% vs 40%, P < .001) increased steadily across the low, intermediate, and high FRS groups, respectively. CONCLUSIONS: There was a significant increase in the percentage of "Appropriate" indications for MSCT when comparing the 2010 to the 2006 ACCF appropriateness criteria. However, in spite of that, there was still significant deviation from the ACCF appropriateness criteria among patients referred for coronary CT angiography in this new MSCT laboratory in a developing country.
BACKGROUND: The aims of this study are to analyze the risk profile and evaluate the appropriateness of patient referral to coronary CT angiography in a new MSCT laboratory in an academic medical center in a developing country. METHODS AND RESULTS: The study population consisted of 100 consecutive patients (mean age 53 ± 13 years, 83% males) who were referred to the new 64 slice MSCT laboratory at the American University of Beirut between July 2008 and July 2009. 52% of patients had chest pain and 48% were asymptomatic. By the 2006 ACCF criteria, only 8% of the referrals fitted the "Appropriate" criteria, 49% were "Inappropriate", and 43% were "Uncertain". The percentage of "Appropriate" indications increased from 8% by the 2006 criteria to 38% by the 2010 ACCF criteria. Framingham risk score (FRS) calculation showed a substantial percentage (46%) of patients to be at low risk, with 32% being at intermediate risk, and 22% at high risk. The prevalence of high calcium score (>400) (0% vs 22%, vs 27%, P < .001) and of obstructive CAD (4% vs 23% vs 40%, P < .001) increased steadily across the low, intermediate, and high FRS groups, respectively. CONCLUSIONS: There was a significant increase in the percentage of "Appropriate" indications for MSCT when comparing the 2010 to the 2006 ACCF appropriateness criteria. However, in spite of that, there was still significant deviation from the ACCF appropriateness criteria among patients referred for coronary CT angiography in this new MSCT laboratory in a developing country.
Authors: Allen J Taylor; Manuel Cerqueira; John McB Hodgson; Daniel Mark; James Min; Patrick O'Gara; Geoffrey D Rubin; Christopher M Kramer; Daniel Berman; Alan Brown; Farooq A Chaudhry; Ricardo C Cury; Milind Y Desai; Andrew J Einstein; Antoinette S Gomes; Robert Harrington; Udo Hoffmann; Rahul Khare; John Lesser; Christopher McGann; Alan Rosenberg; Robert Schwartz; Marc Shelton; Gerald W Smetana; Sidney C Smith Journal: J Am Coll Cardiol Date: 2010-11-23 Impact factor: 24.094
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Authors: Nico R Mollet; Filippo Cademartiri; Carlos A G van Mieghem; Giuseppe Runza; Eugène P McFadden; Timo Baks; Patrick W Serruys; Gabriel P Krestin; Pim J de Feyter Journal: Circulation Date: 2005-10-03 Impact factor: 29.690
Authors: Milind Y Desai; Khurram Nasir; Joel B Braunstein; John A Rumberger; Wendy S Post; Matthew J Budoff; Roger S Blumenthal Journal: Am Heart J Date: 2004-11 Impact factor: 4.749
Authors: Gaetano Nucifora; Joanne D Schuijf; Jacob M van Werkhoven; Roxana Djaberi; Ernst E van der Wall; Albert de Roos; Arthur J H A Scholte; Martin J Schalij; J Wouter Jukema; Jeroen J Bax Journal: Am J Cardiol Date: 2009-07-21 Impact factor: 2.778
Authors: Deepu Nair; Thomas P Carrigan; Ronan J Curtin; Zoran B Popovic; Stacie Kuzmiak; Paul Schoenhagen; Scott D Flamm; Milind Y Desai Journal: Am J Cardiol Date: 2008-05-14 Impact factor: 2.778