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Acceptance of Combined Coronary CT Angiography and Myocardial CT Perfusion versus Conventional Coronary Angiography in Patients with Coronary Stents--Intraindividual Comparison.

Rief M, Feger S, Martus P, Laule M, Dewey M, Schönenberger E - PLoS ONE (2015)

Bottom Line: While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined.Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377).Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (p = 0.097 and p = 0.123, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Charité, Medical School, Berlin, Germany.

ABSTRACT

Objectives: To evaluate how well patients with coronary stents accept combined coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) compared with conventional coronary angiography (CCA).

Background: While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined.

Methods: A total of 90 patients with coronary stents prospectively underwent CTA/CTP (both with contrast agent, CTP with adenosine) and CCA as part of the CARS-320 study. In this group, an intraindividual comparison of patient acceptance of CTA, CTP, and CCA was performed.

Results: CTP was experienced to be significantly more painful than CTA (p<0.001) and was associated with a higher frequency of dyspnea (p<0.001). Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377). Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (p = 0.097 and p = 0.123, respectively). Nevertheless, about two thirds (n = 60, 68%) preferred CTA/CTP to CCA (p<0.001). Moreover, patients felt less helpless during CTA/CTP than during CCA (p = 0.026). Lack of invasiveness and absence of pain were the most frequently mentioned advantages of CTA/CTP over CCA in our patient population.

Conclusions: CCA and combined CTA/CTP are equally well accepted by patients; however, more patients prefer CTA/CTP. CTP was associated with more intense pain than CTA and more frequently caused dyspnea than CTA alone.

Trial registration: ClinicalTrials.gov NCT00967876.

No MeSH data available.


Related in: MedlinePlus

CONSORT Flow Diagram.
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pone.0136737.g001: CONSORT Flow Diagram.

Mentions: Ninety patients with suspected in-stent restenosis and an indication for CCA [13] were included and asked to complete a questionnaire on patient acceptance. Eighty-eight patients answered all questions. Fig 1 shows the CONSORT Flow Diagram of this study. The inclusion and exclusion criteria of the study, the CT protocol, and the clinical indications of each examination have been described in detail before [13]. In brief, the patients first underwent CTA, followed by CTP with adenosine administration. The CT examinations were performed on a CT scanner with a 320-row detector (Aquilion One, Toshiba, Tokio, Japan) [16]. In 62 patients (82%) beta-blockers were administered orally 1h before CTA (atenolol, Tenormin, Astra-Zeneca). An additional intravenous beta-blockade (esmolol, Brevibloc, Baxter) was performed in 15 patients (17%). Contrast medium (Imeron 400, Bracco Imaging, Milano, Italy) was injected into the right cubital vein using a standardized protocol. CTP with adenosine administration was performed after an interval of at least 20 min. Adenosine (Adenosin Life Medical, Carinopharm, Elze, Germany, 140μg/kg/min) was administered through the line in the left antecubital vein using a perfusor system. Approximately 4.5 min after initiation of adenosine administration, a second contrast bolus was administered and the scan was started.


Acceptance of Combined Coronary CT Angiography and Myocardial CT Perfusion versus Conventional Coronary Angiography in Patients with Coronary Stents--Intraindividual Comparison.

Rief M, Feger S, Martus P, Laule M, Dewey M, Schönenberger E - PLoS ONE (2015)

CONSORT Flow Diagram.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556695&req=5

pone.0136737.g001: CONSORT Flow Diagram.
Mentions: Ninety patients with suspected in-stent restenosis and an indication for CCA [13] were included and asked to complete a questionnaire on patient acceptance. Eighty-eight patients answered all questions. Fig 1 shows the CONSORT Flow Diagram of this study. The inclusion and exclusion criteria of the study, the CT protocol, and the clinical indications of each examination have been described in detail before [13]. In brief, the patients first underwent CTA, followed by CTP with adenosine administration. The CT examinations were performed on a CT scanner with a 320-row detector (Aquilion One, Toshiba, Tokio, Japan) [16]. In 62 patients (82%) beta-blockers were administered orally 1h before CTA (atenolol, Tenormin, Astra-Zeneca). An additional intravenous beta-blockade (esmolol, Brevibloc, Baxter) was performed in 15 patients (17%). Contrast medium (Imeron 400, Bracco Imaging, Milano, Italy) was injected into the right cubital vein using a standardized protocol. CTP with adenosine administration was performed after an interval of at least 20 min. Adenosine (Adenosin Life Medical, Carinopharm, Elze, Germany, 140μg/kg/min) was administered through the line in the left antecubital vein using a perfusor system. Approximately 4.5 min after initiation of adenosine administration, a second contrast bolus was administered and the scan was started.

Bottom Line: While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined.Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377).Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (p = 0.097 and p = 0.123, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Charité, Medical School, Berlin, Germany.

ABSTRACT

Objectives: To evaluate how well patients with coronary stents accept combined coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) compared with conventional coronary angiography (CCA).

Background: While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined.

Methods: A total of 90 patients with coronary stents prospectively underwent CTA/CTP (both with contrast agent, CTP with adenosine) and CCA as part of the CARS-320 study. In this group, an intraindividual comparison of patient acceptance of CTA, CTP, and CCA was performed.

Results: CTP was experienced to be significantly more painful than CTA (p<0.001) and was associated with a higher frequency of dyspnea (p<0.001). Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377). Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (p = 0.097 and p = 0.123, respectively). Nevertheless, about two thirds (n = 60, 68%) preferred CTA/CTP to CCA (p<0.001). Moreover, patients felt less helpless during CTA/CTP than during CCA (p = 0.026). Lack of invasiveness and absence of pain were the most frequently mentioned advantages of CTA/CTP over CCA in our patient population.

Conclusions: CCA and combined CTA/CTP are equally well accepted by patients; however, more patients prefer CTA/CTP. CTP was associated with more intense pain than CTA and more frequently caused dyspnea than CTA alone.

Trial registration: ClinicalTrials.gov NCT00967876.

No MeSH data available.


Related in: MedlinePlus