OBJECTIVES: This study was conducted to evaluate the correlation between stress test results and coronary computed tomography angiography (CCTA) findings and comparative diagnostic performance of the 2 modalities in patients undergoing invasive coronary angiography (ICA). BACKGROUND: Recent data suggest that only a third of patients undergoing ICA have obstructive coronary artery disease (CAD); accurate pre-ICA risk stratification is needed. METHODS: At 47 centers participating in the ACIC (Advanced Cardiovascular Imaging Consortium) in Michigan, patients without known CAD who were undergoing CCTA within 3 months of a stress test were studied. Demographics, risk factors, symptoms, and stress test results were correlated with obstructive CAD (>50% stenosis) on CCTA and ICA. RESULTS: Among 6,198 patients (age 56 ± 12 years, 48% men), >50% stenosis was seen in 1,158 (18.7%) on CCTA. Independent predictors included male sex (odds ratio [OR]: 2.37, 95% confidence interval [CI]: 1.83 to 3.06), current smoking (OR: 2.23, 95% CI: 1.57 to 3.17), older age (OR per 10-year increment: 2.14, 95% CI: 1.89 to 2.41), hypertension (OR: 1.8, 95% CI: 1.37 to 2.34), and typical angina (OR: 1.48, 95% CI: 1.03 to 2.12). Stress test results were not predictive. Among patients undergoing ICA (n = 621), there was a strong correlation of ICA with CCTA findings (OR: 9.09, 95% CI: 5.57 to 14.8, p < 0.001), but not stress results (OR: 0.79, 95% CI: 0.56 to 1.11, p = 0.17). CONCLUSIONS: Stress test findings did not predict obstructive CAD on CCTA, observed in <20% of patients in this large study group. The strong association of CCTA with ICA suggests that it may serve as an effective "gatekeeper" to invasive testing in patients needing adjudication of stress test results. (Advanced Cardiovascular Imaging Consortium: A Collaborative Quality Improvement Project [ACIC]; NCT00640068).
OBJECTIVES: This study was conducted to evaluate the correlation between stress test results and coronary computed tomography angiography (CCTA) findings and comparative diagnostic performance of the 2 modalities in patients undergoing invasive coronary angiography (ICA). BACKGROUND: Recent data suggest that only a third of patients undergoing ICA have obstructive coronary artery disease (CAD); accurate pre-ICA risk stratification is needed. METHODS: At 47 centers participating in the ACIC (Advanced Cardiovascular Imaging Consortium) in Michigan, patients without known CAD who were undergoing CCTA within 3 months of a stress test were studied. Demographics, risk factors, symptoms, and stress test results were correlated with obstructive CAD (>50% stenosis) on CCTA and ICA. RESULTS: Among 6,198 patients (age 56 ± 12 years, 48% men), >50% stenosis was seen in 1,158 (18.7%) on CCTA. Independent predictors included male sex (odds ratio [OR]: 2.37, 95% confidence interval [CI]: 1.83 to 3.06), current smoking (OR: 2.23, 95% CI: 1.57 to 3.17), older age (OR per 10-year increment: 2.14, 95% CI: 1.89 to 2.41), hypertension (OR: 1.8, 95% CI: 1.37 to 2.34), and typical angina (OR: 1.48, 95% CI: 1.03 to 2.12). Stress test results were not predictive. Among patients undergoing ICA (n = 621), there was a strong correlation of ICA with CCTA findings (OR: 9.09, 95% CI: 5.57 to 14.8, p < 0.001), but not stress results (OR: 0.79, 95% CI: 0.56 to 1.11, p = 0.17). CONCLUSIONS: Stress test findings did not predict obstructive CAD on CCTA, observed in <20% of patients in this large study group. The strong association of CCTA with ICA suggests that it may serve as an effective "gatekeeper" to invasive testing in patients needing adjudication of stress test results. (Advanced Cardiovascular Imaging Consortium: A Collaborative Quality Improvement Project [ACIC]; NCT00640068).
Authors: Brian S Ko; Dennis T L Wong; James D Cameron; Darryl P Leong; Michael Leung; Ian T Meredith; Nitesh Nerlekar; Paul Antonis; Marcus Crossett; John Troupis; Richard Harper; Yuvaraj Malaiapan; Sujith K Seneviratne Journal: Eur Radiol Date: 2013-11-12 Impact factor: 5.315
Authors: Anthony N DeMaria; Jeroen J Bax; Gregory K Feld; Barry H Greenberg; Jennifer L Hall; Mark A Hlatky; Wilbur Y W Lew; João A C Lima; Ehtisham Mahmud; Alan S Maisel; Sanjiv M Narayan; Steven E Nissen; David J Sahn; Sotirios Tsimikas Journal: J Am Coll Cardiol Date: 2013-01-22 Impact factor: 24.094
Authors: Andrew J Einstein; Daniel S Berman; James K Min; Robert C Hendel; Thomas C Gerber; J Jeffrey Carr; Manuel D Cerqueira; S James Cullom; Robert DeKemp; Neal W Dickert; Sharmila Dorbala; Reza Fazel; Ernest V Garcia; Raymond J Gibbons; Sandra S Halliburton; Jörg Hausleiter; Gary V Heller; Scott Jerome; John R Lesser; Gilbert L Raff; Peter Tilkemeier; Kim A Williams; Leslee J Shaw Journal: J Am Coll Cardiol Date: 2014-02-13 Impact factor: 24.094
Authors: Grace Ronan; Michael J Wolk; Steven R Bailey; John U Doherty; Pamela S Douglas; Robert C Hendel; Christopher M Kramer; James K Min; Manesh R Patel; Lisa Rosenbaum; Leslee J Shaw; Raymond F Stainback; Joseph M Allen; Ralph G Brindis; Christopher M Kramer; Leslee J Shaw; Manuel D Cerqueira; Jersey Chen; Larry S Dean; Reza Fazel; W Gregory Hundley; Dipti Itchhaporia; Paul Kligfield; Richard Lockwood; Joseph Edward Marine; Robert Benjamin McCully; Joseph V Messer; Patrick T O'Gara; Richard J Shemin; L Samuel Wann; John B Wong; Manesh R Patel; Christopher M Kramer; Steven R Bailey; Alan S Brown; John U Doherty; Pamela S Douglas; Robert C Hendel; Bruce D Lindsay; James K Min; Leslee J Shaw; Raymond F Stainback; L Samuel Wann; Michael J Wolk; Joseph M Allen Journal: J Nucl Cardiol Date: 2014-02 Impact factor: 5.952
Authors: Michael E Layoun; Eric H Yang; Joerg Herrmann; Cezar A Iliescu; Juan C Lopez-Mattei; Kostas Marmagkiolis; Matthew J Budoff; Maros Ferencik Journal: Curr Treat Options Oncol Date: 2019-05-06