Acceptance of noninvasive computed tomography coronary angiography: for a patient-friendly medicine

Grutta, Ludovico La; Grutta, Sabina La; Gallucci, M.; Piccolo, Giuseppe Lo; Gentile, Giovanni; Tona, Giuseppe La; Epifanio, Maria Stella; Maffei, Erica; Cademartiri, Filippo; Baido, Rosa Lo; Lagalla, Roberto; Midiri, Massimo

doi:10.1007/s11547-013-0319-2

Cited by 10 publications

(7 citation statements)

References 39 publications

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“…8 9 Indeed, many studies have suggested a high degree of short-term patient satisfaction and preference for CTCA. [10][11][12][13] Here, we have investigated the additional effect of CTCA on the improvements in patients' symptoms following attendance at the rapid access chest pain clinic that included an exercise test in the majority (85%) of attendances. We have made a number of notable and novel observations, some of which may initially seem counterintuitive.…”

Section: Discussionmentioning

confidence: 99%

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Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial

Williams

Hunter

Shah

et al. 2017

Heart

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BackgroundIn patients with suspected angina pectoris, CT coronary angiography (CTCA) clarifies the diagnosis, directs appropriate investigations and therapies, and reduces clinical events. The effect on patient symptoms is currently unknown.MethodsIn a prospective open-label parallel group multicentre randomised controlled trial, 4146 patients with suspected angina due to coronary heart disease were randomised 1:1 to receive standard care or standard care plus CTCA. Symptoms and quality of life were assessed over 6 months using the Seattle Angina Questionnaire and Short Form 12.ResultsBaseline scores indicated mild physical limitation (74±0.4), moderate angina stability (44±0.4), modest angina frequency (68±0.4), excellent treatment satisfaction (92±0.2) and moderate impairment of quality of life (55±0.3). Compared with standard care alone, CTCA was associated with less marked improvements in physical limitation (difference −1.74 (95% CIs, −3.34 to −0.14), p=0.0329), angina frequency (difference −1.55 (−2.85 to −0.25), p=0.0198) and quality of life (difference −3.48 (−4.95 to −2.01), p<0.0001) at 6 months. For patients undergoing CTCA, improvements in symptoms were greatest in those diagnosed with normal coronary arteries or who had their preventative therapy discontinued, and least in those with moderate non-obstructive disease or had a new prescription of preventative therapy (p<0.001 for all).ConclusionsWhile improving diagnosis, treatment and outcome, CTCA is associated with a small attenuation of the improvements in symptoms and quality of life due to the detection of moderate non-obstructive coronary artery disease.Trial registration number:NCT01149590.

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Section: Discussionmentioning

confidence: 99%

“…The study design has previously been described 4 and the primary findings published. 12 Participants Participants were recruited from a dedicated cardiology chest pain clinic where they were referred with suspected angina due to coronary heart disease. A total of 4146 patients aged 18-75 were recruited as described previously.…”

Section: Methodsmentioning

confidence: 99%

Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial

Williams

Hunter

Shah

et al. 2017

Heart

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“…Nowadays, the increase in longevity and the development of new diagnostic and therapeutic strategies lead to a raise in the number of people submitted to diagnostic, screening or follow-up examinations [2]. The direct consequence has been the prevention and the improvement of the outcome of many diseases.…”

Section: Discussionmentioning

confidence: 99%

“…Anxiety is mainly due to the fear of the uncertainty of procedure, results of the examination, and possible consequence of invasive or not and health impairment [2].…”

Section: Introductionmentioning

confidence: 99%

Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study

Luca

Muscarneri

et al. 2016

Radiol med

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submitted to MR, 18 % to breast imaging, 10 % to X-ray, 22 % Computer Tomography and 19 % to ultrasound, as previously described. 41 % of patients were submitted to the examination because of an oncologic disease, while 59 % because of non-oncological disease. Therefore, it was found that high levels of anxiety were present in most (about 91 %) of the patients and the scores varied according to the imaging examination and to the examination's reason: anxiety level was higher in non-oncological patients (54 %) and in patients waiting to undergo to MRI exams (29 %). Conclusion Our data suggest that the diagnostic exams are stressful events for the patient, also in non-oncological patients. So, it is important to adequate the radiological staff to receive the patient, to inform him and perform AbstractObjective Every patient could feel anxious when he waits in a radiological department to undergo diagnostic exams. The aim of our study is to evaluate the impact of the radiological exams on patient anxiety. Materials and methods

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“…The following step could be to place these results in a prognostic context in comparison with CMR which, in current-day practice, is considered the most accurate tool for infarct characterization in clinical setting. The health technology assessment should be also completed with cost-effectiveness and economic sustainability study (120,121). A one stopshop examination with a profile of first-line imaging could be a solution to cut economic and biological costs in the work-up of patients with suspected or known CAD.…”

Section: Discussionmentioning

confidence: 99%

Infarct characterization using CT

Grutta

Toia

Maffei

et al. 2017

Cardiovasc. Diagn. Ther.

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Myocardial infarction (MI) is a major cause of death and disability worldwide. The incidence is not expected to diminish, despite better prevention, diagnosis and treatment, because of the ageing population in industrialized countries and unhealthy lifestyles in developing countries. Nowadays it is highly requested an imaging tool able to evaluate MI and viability. Technology improvements determined an expansion of clinical indications from coronary plaque evaluation to functional applications (perfusion, ischemia and viability after MI) integrating additional phases and information in the mainstream examination.Cardiac computed tomography (CCT) and cardiac MR (CMR) employ different contrast media, but may characterize MI with overlapping imaging findings due to the similar kinetics and tissue distribution of gadolinium and iodinated contrast media. CCT may detect first-pass perfusion defects, dynamic perfusion after pharmacological stress, and delayed enhancement (DE) of non-viable territories.

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Acceptance of noninvasive computed tomography coronary angiography: for a patient-friendly medicine

Cited by 10 publications

References 39 publications

Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial

Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial

Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study

Infarct characterization using CT

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