Invasive coronary angiography is the final diagnosis of obstructive coronary artery disease (CAD). However, some studies suggest that invasive coronary angiography has a low diagnostic yield. Computed tomography (CT) has emerged as a more accurate non-invasive test of CAD. This study aims to evaluate the effectiveness of invasive coronary angiography and computed tomography (CT) in patients with an intermediate probability of CAD.
This prospective randomized single-center trial included a total of 340 patients with suspected CAD, along with a clinical indication for coronary angiography on the basis of chest pain or atypical angina. The primary outcome of the study was the incidence of major procedural complications within 48 hours after CT or angiography.
The findings suggested that cardiac CT reduced the need for coronary angiography from 100% to 14% and also resulted in a significantly greater diagnostic yield. Major procedural complications were not common and were similar across the two groups. Minor procedural complications were less common with CT compared with angiography. After 3.3 years of follow-up, adverse cardiovascular events occurred in 4.2% of patients in the CT group and 3.7% of patients in the angiography group.
The research concluded that CT increased diagnostic yield and reduced the need for angiography in patients with probable CAD.
Ref: https://www.bmj.com/content/355/bmj.i5441
