Table 4.
Studies Reporting CCTA Impact on Patient Management and/or Outcomes
| Author | Year | Setting | Sample Size | Age (Mean, SD) | % Male | CAD Risk | Follow-Up | Diagnosis Method | Major Findings |
|---|---|---|---|---|---|---|---|---|---|
| Danciu | 2007 | OP | 421 | 64 (12) | 63% | Intermediate | 12 months | SPECT, ICA, MACE | Event rate 0.3% in low risk group vs. 70.5% for ICA |
| Goldstein | 2007 | ED | 99 | 48 (11) | 43% | Very low | 6 months | ICA, repeat testing (MACE) | CCTA correctly and definitively diagnosed in 95% |
| Gallagher | 2007 | ED | 85 | 49 (11) | 53% | Low | 30 days | ICA, record review, clinical follow-up | No events recorded; CCTA+ in 6 of 7 w/confirmed ACS |
| Hoffmann | 2006 | ED | 103 | 54 (12) | 60% | Low | Mean: 5.2 months | Record review (ACS) | Sensitivity 100% for ACS, specificity 82% |
| Hollander | 2007 | ED | 54 | 47 (9) | 46% | Low | 30 days | Survey, record review (CV death/MI) | No events recorded; CAD confirmed in 4 of 6 CCTA (+) patients |
| Johnson | 2007 | ED | 55 | 67 (10) | 64% | N/A | ≥5 months | Record review, repeat enzymes | CCTA correctly and definitively diagnosed in 93% |
| Pundziute | 2007 | OP | 100 | 59 (12) | 73% | Intermediate | Mean: 16 months | Record review, clinic visits, survey | 1-yr event rate 0% in CCTA (−) patients; 30% in CCTA (+) |
| Rubinshtein | 2007 | ED | 58 | 56 (10) | 64% | Intermediate | 12 months | Altered strategies, f/u survey | Canceled hospitalization in 45%; no events in CCTA (−) |
| Savino | 2006 | ED | 23 | 56 (13) | 61% | N/A | ED visit only | Record review | All significant stenoses on CCTA confirmed by ICA |
| Hay | 2009 | OP | 138 | 57 (median) | 53% | Intermediate | Mean: 19.9 months | Electronic record review | No MACE events in CCTA (−) patients; 8 of 22 CCTA (+) patients revascularized |
| Wagdi | 2009 | OP | 347 | 68 (12) | 71% | Low-to-intermediate | Mean: 16 months | Clinical visits/phone interviews | 90% reduction in rate of normal ICA; 190% reduction in self-referred ICA |
CAD: coronary artery disease; RCT: randomized controlled trial; MACE: major adverse cardiovascular event; CCTA: coronary computed tomographic angiography; ED: emergency department; OP: Outpatient