Impact of Clinical Guideline Recommendations on the Application of Coronary Computed Tomographic Angiography in Patients with Suspected Stable Coronary Artery Disease

被引:0
作者
Zhou Jia [1 ,2 ,3 ,4 ,5 ,6 ,7 ,4 ]
Yang JunJie [8 ,2 ,3 ,4 ]
Yang Xia [8 ,2 ,3 ,4 ]
Chen ZhiYe [9 ,2 ,3 ,4 ]
He Bai [8 ,2 ,3 ,4 ]
Du LuoShan [9 ,2 ,3 ,4 ]
Chen YunDai
机构
[1] Medical School of Chinese PLA
[2] PLA General Hospital
[3] Beijing
[4] China
[5] Department of Cardiology
[6] Tianjin Chest Hospital
[7] Tianjin
[8] Department of Cardiology
[9] Department of Radiology
基金
中国国家自然科学基金;
关键词
Clinical Practice; Coronary Computed Tomographic Angiography; Coronary Artery Disease; Guideline Recommendations;
D O I
暂无
中图分类号
R543.3 [冠状动、静脉疾病]; R816.2 [心脏血管系];
学科分类号
1002 ; 100201 ; 1001 ; 100105 ; 100207 ; 100602 ;
摘要
Background: Coronary computed tomographic angiography (CCTA) has been widely used in patients who are at intermediate risk for having stable coronary artery disease (SCAD), and 2013 European Society of Cardiology Guidelines on the Management of SCAD (2013G) recommended the appropriate application of CCTA. However, 2013G has not been subjected to systematic analyses for subsequent impact on clinical practice. Methods: A total of 5320 patients suspected with SCAD were enrolled and scheduled for CCTA from March 2013 to September 2014. For each patient, pretest probability of SCAD was calculated according to updated Diamond-Forrester model (UDFM). Appropriate CCTA or appropriate stress test was determined as described in the 2013G. A generalized estimating equation model was used to determine the trends in the half-monthly rate of appropriate CCTA. Results: Overall, only 61.37% of patients received appropriate CCTA, and there was insignificant change over time (P = 0.8701). The application of CCTA in patients who should have had a stress test accounted for most of the inappropriate CCTA before (22.29%) or after (19.98%) the publication of the 2013G. In all patients or any subgroup, no significant change in the adjusted half-monthly rate of appropriate CCTA was found after the publication of the 2013G (odds ratio, 1.002; 95% confidence interval, 0.982–1.021;P = 0.8678).Conclusions: These findings suggest that the 2013G have not, to date, been fully incorporated into clinical practice, and the clinical utilization of CCTA remains unreasonable to some extent.
引用
收藏
页码:135 / 141
页数:7
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