Document Detail


Computed Tomography Coronary Angiography Versus Stress Myocardial Perfusion Imaging for Risk Stratification in Patients With High Occupational Risk.
MedLine Citation:
PMID:  21263354     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To compare the performance of myocardial perfusion imaging (MPI) versus cardiac computed tomographic angiography (CCTA) in patients with a low pretest likelihood of obstructive coronary artery disease and high-risk occupation. MATERIALS AND METHODS: We performed a retrospective chart review of all MPI and CCTA studies performed at our institution from January 2006 to May 2008. The primary outcome measure was the incidence of referral to invasive coronary angiography (ICA). RESULTS: There were 512 MPS and 170 CCTA studies performed during the study period that met the study criteria. The average age was 35±10 for the CCTA arm and 45±5 for the myocardial perfusion scans (MPS) arm, which was statistically significant (P<0.001), with similar sex distribution between the 2 arms (21% female patients in the MPI arm and 20% female patients in the CCTA arm). The incidence of referral to ICA was 15.8% (81/512) after MPS versus 2.4% (4/170) with CCTA (P<0.001). Among patients referred for ICA, the false-positive rate was 93% (75/81) and 50% (2/4) with MPI and CCTA, respectively (P=0.043). CONCLUSIONS: Compared with MPI, CCTA significantly reduced ICA referral and false-positive noninvasive imaging rates among symptomatic patients with a low probability of coronary artery disease but high occupational risk.
Authors:
Jennifer Slim; Laudino Castillo-Rojas; Matt Hann; John Symons; Shaun Martinho; Jison Sim; Santiago Jimenez; Brian Haney; Todd C Villines; Eric A Shry; Ahmad M Slim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-1-21
Journal Detail:
Title:  Journal of thoracic imaging     Volume:  -     ISSN:  1536-0237     ISO Abbreviation:  -     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-1-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8606160     Medline TA:  J Thorac Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
*Cardiology Service, Brooke Army Medical Center, San Antonio, TX †Walter Reed Army Medical Center, Washington, DC ‡Cardiology Service, Landstuhl Regional Medical Center, Landstuhl, Germany.
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