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Coronary computed tomography angiography (CCTA) in patients with suspected stable coronary artery disease (CAD): diagnostic impact and clinical consequences in the German Cardiac CT Registry depending on stress test results

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Abstract

To evaluate diagnostic impact of clinical use of coronary computed tomography angiography (CCTA) in patients with suspected stable coronary artery disease (CAD) and its consequences in daily practice for patient management, depending on stress test results in daily practice. Between 2009 and 2014 of a total population of 1352 patients of the German Cardiac Computed Tomography (CT) Registry who had previously undergone stress tests, CCTA visualizations were carried out on the coronary arteries with suspected stable CAD. Patients were divided into three groups according to stress test results: Group 1 with inconclusive (n = 178, 13.2%), Group 2 with ischemia in stress test (n = 372, 27.5%) and Group 3 without ischemia in stress test (n = 802, 59.3%). The test of preference was the stress electrocardiogram (ECG), which was performed more frequently in patients without ischemia in stress test as compared to those with ischemia (96.3% vs. 93.0%, p = 0.015). The incidence of detected obstructive CAD was lower in patients with suggested ischemia in stress test as compared to patients with inconclusive results (14.1% vs. 21.1%, p = 0.037). There was no difference in the incidence of an obstructive CAD in patients with and without ischemia in stress test (14.1% vs. 15.8%, p = 0.440). CCTA is a reliable, non-invasive option for ruling-out obstructive CAD irrespective of the stress test result.

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Acknowledgements

We are indebted to all participants of the registry and the staff of the Stiftung Institut für Herzinfarktforschung of Ludwigshafen, Germany.

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Authors and Affiliations

  1. Department of Cardiology, Cardiovascular Center Bad Neustadt/Saale, Salzburger Leite 1, 97616, Bad Neustadt/Saale, Germany

    Sebastian Barth, Sebastian Kerber, Karsten Hamm & Frank Gietzen

  2. Department of Cardiology, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Erlangen, Germany

    Mohamed Marwan & Stephan Achenbach

  3. Munich and German Heart Center Munich, Ludwig-Maximilians-Universität, Munich, Germany

    Jörg Hausleiter

  4. Klinikum Traunstein, Traunstein, Germany

    Werner Moshage

  5. Department of Cardiology & Vascular Medicine, GRN Hospital Weinheim, Weinheim, Germany

    Grigorios Korosoglou

  6. Klinik für Kardiologie und Intensivmedizin, Klinikum Bogenhausen, Munich, Germany

    Alexander Leber

  7. Cardioangiologisches Centrum Bethanien, Frankfurt, Germany

    Axel Schmermund

  8. Klinische Kardiologie II, Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany

    Helmut Gohlke

  9. Department of Cardiology and Angiology, Contilia Heart and Vascular Center, Elisabeth Hospital Essen, Essen, Germany

    Oliver Bruder

  10. Department of Internal Medicine, Krankenhaus Benrath, Düsseldorf, Germany

    Thorsten Dill

  11. Klinik am Eichert, Göppingen, Germany

    Stephen Schröder

  12. Institute for Myocardial Infarction Research, Ludwigshafen, Germany

    Steffen Schneider & Jochen Senges

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  1. Sebastian Barth
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  2. Mohamed Marwan
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  3. Jörg Hausleiter
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  7. Axel Schmermund
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  8. Helmut Gohlke
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  9. Oliver Bruder
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  12. Sebastian Kerber
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  13. Karsten Hamm
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  14. Frank Gietzen
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  15. Steffen Schneider
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  17. Stephan Achenbach
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Corresponding author

Correspondence to Sebastian Barth.

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Conflict of interest

Stephan Achenbach has received research grants from Siemens Healthcare. Mohamed Marwan has received speaker honoraria from Siemens Healthcare. All patients at participating sites gave written informed consent for CT scan and inclusion in the registry. The registry was approved by the participating institution's IRBs.

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Barth, S., Marwan, M., Hausleiter, J. et al. Coronary computed tomography angiography (CCTA) in patients with suspected stable coronary artery disease (CAD): diagnostic impact and clinical consequences in the German Cardiac CT Registry depending on stress test results. Int J Cardiovasc Imaging 35, 741–748 (2019). https://doi.org/10.1007/s10554-018-1504-0

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  • DOI: https://doi.org/10.1007/s10554-018-1504-0

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