MI incidence down with CT angiography in suspected CAD
Andrew J. Foy, M.D., from the Penn State College of Medicine in Hershey, and colleagues conducted a systematic review of 13 randomized trials involving patients with suspected CAD. Overall, 10,315 patients were in the CCTA arm and 9,777 in the functional stress testing arm, with a mean follow-up of 18 months.
The researchers found that no statistically significant differences were seen between CCTA and functional stress testing in death (1 versus 1.1 percent; risk ratio [RR], 0.93; 95 percent confidence interval [CI], 0.71 to 1.21) or cardiac hospitalization (2.7 versus 2.7 percent; RR,0.98; 95 percent CI, 0.79 to 1.21). CCTA correlated with reduced myocardial infarction incidence (0.7 versus 1.1 percent; RR, 0.71; 95 percent CI, 0.53 to 0.96). It also correlated with elevated likelihood of undergoing invasive coronary angiography (11.7 versus 9.1 percent; RR, 1.33; 95 percent CI, 1.12 to 1.59) and revascularization (7.2 versus 4.5 percent; RR, 1.86; 95 percent CI, 1.43 to 2.43). Patients undergoing CCTA were also more likely to receive a diagnosis of new CAD and have started aspirin or statin therapy.
"CCTA is not associated with a reduction in mortality or cardiac hospitalizations," the authors write.
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