Coronary CT angiography findings modify statin, aspirin Rx
Amit Pursnani, M.D., from Massachusetts General Hospital in Boston, and colleagues examined whether knowledge of CCTA-based CAD correlated with modification of statin and aspirin prescription. Data were included from the CCTA arm of the Rule Out Myocardial Infarction using Computed Angiographic Tomography II multicenter, randomized control trial (R-II; 370 patients), and the comparison cohort from the Rule Out Myocardial Infarction using Computed Angiographic Tomography I cohort (R-I; 277 patients).
The rate of acute coronary syndrome was similar for R-I and R-II (6.9 and 6.2 percent, respectively; P = 0.75). The researchers found that statin initiation was greater after disclosure of CCTA results among patients with CCTA-detected obstructive CAD without ACS (0 percent in R-I versus 20 percent in R-II; P = 0.009). Aspirin prescription was lower with disclosure of CCTA results among patients without CCTA-detected CAD (16 percent in R-I versus 4.8 percent in R-II; P = 0.001). Within R-II, only 68 and 65 percent of patients with obstructive CAD were discharged on statin and aspirin, respectively.
"Our findings suggest opportunity for practice improvement when CCTA is performed in the emergency department," the authors write.
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