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CT Compared With ICA for Evaluating Stable Chest Pain

From Health Day News – In patients with moderate to severe chest pain and the probability of moderate coronary artery disease (CAD) diagnosis of invasive coronary angiography (ICA), the risk of serious cardiovascular events is similar to the use of computed tomography (CT) or ICA, according to a study published online on March 4 in the New England Journal of Medicine. The study was published in conjunction with the annual European Congress of Radiology, held about March 2 to 6.

Pál Maurovich-Horvat, MD, Ph.D., MPH, of Semmelweis University in Budapest, Hungary, and colleagues compared CT and ICA as the first imaging techniques to guide the treatment of patients with stable and moderate chest pain preventive CAD tests. The main result was severe cardiovascular events during 3.5 years. A total of 3,561 patients were included in the analysis: 1,808 in the CT group and 1,753 in the ICA group.

The researchers found that serious cardiac events occurred in 2.1 and 3.0 percent of patients in the CT and ICA groups, respectively (risk ratio, 0.70; 95% confidence interval, 0.46 to 1.07; P = 0.10 ). Major systemic complications occurred in 0.5 and 1.9 percent of patients in the CT and ICA groups, respectively (risk ratio, 0.26; confidence interval 95%, 0.13 to 0.55). Angina was reported within the last four weeks of 8.8 and 7.5 percent of patients in the CT and ICA groups, respectively (odds ratio, 1.17; confidence interval 95 percent, 0.92 to 1.48 percent).

“We found that the first CT strategy did not cause a significant difference in major cardiovascular events compared to ICA but was associated with a lower risk of major complications related to the procedure and rehabilitation processes,” the authors wrote.

Many authors disclosed financial ties to the biopharmaceutical and medical device industries.

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