Lauren H Goldman1, Rikah Lerer2, Cyrus Shabrang2, Mark I Travin2,3, Jeffrey M Levsky2,3. 1. Department of Radiology, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA. lauren.a.hackney@gmail.com. 2. Department of Radiology, Montefiore Medical Center, 111 E. 210th Street, Bronx, NY, 10467, USA. 3. Department of Medicine, Division of Cardiology, Montefiore Medical Center, Bronx, NY, USA.
Abstract
BACKGROUND: The effect of incidental findings from coronary computed tomography angiography (CCTA) on management has not been rigorously investigated. This study uses a control group to explore this relationship. METHODS: Analysis of data from a randomized controlled trial of acute chest pain patients admitted to telemetry was performed. Patients were randomized to undergo either CCTA (n = 200) or radionuclide myocardial perfusion imaging (MPI) (n = 200). Incidental findings were determined from imaging reports. Records were reviewed to determine subsequent management and imaging during and after hospitalization. Comparisons were performed using Fischer's exact tests. RESULTS: 386 incidental findings were found among 187 CCTA studies. No extra-cardiac incidental findings were noted in the MPI arm, which served as an effective control group. There were significantly more non-coronary medical workups during admission in the CCTA group compared to the MPI group [20% (39) vs. 12% (23), P = 0.038]. CCTA patients underwent significantly more resting echocardiography during the inpatient workup compared to the MPI group [38% (75) vs. 18% (55), P = 0.042]. CCTA patients underwent significantly more non-contrast chest CT exams in the year following admission compared to MPI patients [14% (27) vs. 7% (13) P = 0.029]. CONCLUSIONS: Incidental findings on inpatient CCTAs performed for chest pain have a significant impact on treatment and imaging during and following hospital admission.
BACKGROUND: The effect of incidental findings from coronary computed tomography angiography (CCTA) on management has not been rigorously investigated. This study uses a control group to explore this relationship. METHODS: Analysis of data from a randomized controlled trial of acute chest pain patients admitted to telemetry was performed. Patients were randomized to undergo either CCTA (n = 200) or radionuclide myocardial perfusion imaging (MPI) (n = 200). Incidental findings were determined from imaging reports. Records were reviewed to determine subsequent management and imaging during and after hospitalization. Comparisons were performed using Fischer's exact tests. RESULTS: 386 incidental findings were found among 187 CCTA studies. No extra-cardiac incidental findings were noted in the MPI arm, which served as an effective control group. There were significantly more non-coronary medical workups during admission in the CCTA group compared to the MPI group [20% (39) vs. 12% (23), P = 0.038]. CCTA patients underwent significantly more resting echocardiography during the inpatient workup compared to the MPI group [38% (75) vs. 18% (55), P = 0.042]. CCTA patients underwent significantly more non-contrast chest CT exams in the year following admission compared to MPI patients [14% (27) vs. 7% (13) P = 0.029]. CONCLUSIONS: Incidental findings on inpatient CCTAs performed for chest pain have a significant impact on treatment and imaging during and following hospital admission.
Authors: Onno M Mets; Ewoud J Smit; Firdaus A A Mohamed Hoesein; Hester A Gietema; Reinoud P H Bokkers; Mohamed Attrach; Saskia van Amelsvoort-van de Vorst; Ernst Th Scholten; Constantinus F M Buckens; Matthijs Oudkerk; Jan-Willem J Lammers; Mathias Prokop; Pim A de Jong Journal: PLoS One Date: 2012-07-27 Impact factor: 3.240
Authors: Mouaz H Al-Mallah; Timothy M Bateman; Kelley R Branch; Andrew Crean; Eric L Gingold; Randall C Thompson; Sarah E McKenney; Edward J Miller; Venkatesh L Murthy; Koen Nieman; Todd C Villines; Michael V Yester; Andrew J Einstein; John J Mahmarian Journal: J Nucl Cardiol Date: 2022-09-02 Impact factor: 3.872