CHICAGO — The use of 64-slice computed tomography coronary angiography seems to render invasive angiography unnecessary in many intermediate-risk patients, Dr. Mark A. Peterman reported at the annual meeting of the Society for Cardiovascular Angiography and Interventions.
Dr. Peterman observed the first 100 consecutive patients referred for 64-slice CT angiography for the indications of chest pain or an abnormal stress test following the installation of the imaging system at Baylor University Medical Center, Dallas.
Of those referred patients, 85 were reclassified as low risk on the basis of normal CT scans in the curved reformat, maximum-intensity pixel, and 3-D reconstruction views, said Dr. Peterman, of the university.
During 6 months of follow-up, there have been no coronary events in this group.
In the remaining 15 patients, whose CT findings were abnormal or suspicious, invasive coronary angiography was ordered by their primary cardiologists a mean of 20 days after CT angiography. The correlation between CT and conventional angiography proved to be excellent.
Thus, CT coronary angiography could obviate the need for invasive angiography in a significant number of intermediate-risk patients, although the real-world experience documented in this study requires confirmation in a larger, controlled study with longer follow-up. A cost-effectiveness analysis would be a useful component of any such study, Dr. Peterman added.