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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

Pain intensity.Boxplot of pain intensities patients reported for CTA/CTP and CCA on the horizontal visual analogue scale (0–100mm) and corresponding intraindividual comparison between the 68 patients who experienced pain during at least one examination; n = 36 pain CCA> CTA/CTP; n = 24 pain CTA/CTP> CCA; n = 8 pain CTA/CTP = CCA; p = 0.121 using the chi-square test.
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pone.0136737.g002: Pain intensity.Boxplot of pain intensities patients reported for CTA/CTP and CCA on the horizontal visual analogue scale (0–100mm) and corresponding intraindividual comparison between the 68 patients who experienced pain during at least one examination; n = 36 pain CCA> CTA/CTP; n = 24 pain CTA/CTP> CCA; n = 8 pain CTA/CTP = CCA; p = 0.121 using the chi-square test.

Mentions: Twenty patients (23%) reported no pain with either procedure. Seventeen patients (19%) reported subjective pain for only one procedure–five for CTA/CTP and 12 for CCA. Over half of the patients reported pain for both procedures (n = 51, 58%). The averaged pain intensity ratings of all 88 patients did not differ significantly between CTA/CTP (16±23) and CCA (20±26) (p = 0.141; Fig 2A). One patient reported maximum pain for CCA during puncture and while the introducer sheath was pulled out; another five patients also reported high pain intensity at the puncture site in the groin (75 to 95 on the VAS, Fig 2B). For CTA/CTP, high pain intensity (75 to 80 on the VAS) was reported by five patients (uncomfortable position and cold: n = 3; adenosine-related chest pain: n = 2). CTA was experienced to cause markedly less intense pain (4±9) than CTP (12±18; p<0.001). Chest pain was more common during CTP than during CTA (n = 22; 25% versus n = 4; 5%; p<0.001).


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)

Pain intensity.Boxplot of pain intensities patients reported for CTA/CTP and CCA on the horizontal visual analogue scale (0–100mm) and corresponding intraindividual comparison between the 68 patients who experienced pain during at least one examination; n = 36 pain CCA> CTA/CTP; n = 24 pain CTA/CTP> CCA; n = 8 pain CTA/CTP = CCA; p = 0.121 using the chi-square test.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0136737.g002: Pain intensity.Boxplot of pain intensities patients reported for CTA/CTP and CCA on the horizontal visual analogue scale (0–100mm) and corresponding intraindividual comparison between the 68 patients who experienced pain during at least one examination; n = 36 pain CCA> CTA/CTP; n = 24 pain CTA/CTP> CCA; n = 8 pain CTA/CTP = CCA; p = 0.121 using the chi-square test.
Mentions: Twenty patients (23%) reported no pain with either procedure. Seventeen patients (19%) reported subjective pain for only one procedure–five for CTA/CTP and 12 for CCA. Over half of the patients reported pain for both procedures (n = 51, 58%). The averaged pain intensity ratings of all 88 patients did not differ significantly between CTA/CTP (16±23) and CCA (20±26) (p = 0.141; Fig 2A). One patient reported maximum pain for CCA during puncture and while the introducer sheath was pulled out; another five patients also reported high pain intensity at the puncture site in the groin (75 to 95 on the VAS, Fig 2B). For CTA/CTP, high pain intensity (75 to 80 on the VAS) was reported by five patients (uncomfortable position and cold: n = 3; adenosine-related chest pain: n = 2). CTA was experienced to cause markedly less intense pain (4±9) than CTP (12±18; p<0.001). Chest pain was more common during CTP than during CTA (n = 22; 25% versus n = 4; 5%; p<0.001).

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