Combined stress myocardial CT perfusion and coronary CT angiography as a feasible strategy among patients presenting with acute chest pain to the emergency department. (Record no. 8866)

000 -LEADER
fixed length control field 03457nam a22004577a 4500
008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION
fixed length control field 200902s20202020 xxu||||| |||| 00| 0 eng d
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
Classification number 32807703
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1876-861X
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code S1934-5925(20)30368-3 [pii]
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1016/j.jcct.2020.06.195 [doi]
190 ## -
-- Grandhi GR
190 ## -
-- Batlle JC
190 ## -
-- Maroules CD
190 ## -
-- Janowitz W
190 ## -
-- Pena CS
190 ## -
-- Ziffer JA
190 ## -
-- Macedo R
190 ## -
-- Nasir K
190 ## -
-- Cury RC
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Grandhi, Gowtham R
245 ## - TITLE STATEMENT
Title Combined stress myocardial CT perfusion and coronary CT angiography as a feasible strategy among patients presenting with acute chest pain to the emergency department.
251 ## -
-- Journal of cardiovascular computed tomography. 2020 Jul 29
252 ## -
-- J Cardiovasc Comput Tomogr. 2020 Jul 29
253 ## -
-- Journal of cardiovascular computed tomography
260 ## - PUBLICATION, DISTRIBUTION, ETC.
-- aheadofprint
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Date of publication, distribution, etc. 2020
269 ## -
-- FY2021
520 ## - SUMMARY, ETC.
Summary, etc. BACKGROUND: A combined approach of myocardial CT perfusion (CTP) with coronary CT angiography (CTA) was shown to have better diagnostic accuracy than coronary CTA alone. However, data on cost benefits and length of stay when compared to other perfusion imaging modalities has not been evaluated. Therefore, we aim to perform a feasibility study to assess direct costs and length of stay of a combined stress CTP/CTA and use SPECT myocardial perfusion imaging (SPECT-MPI) as a benchmark, among chest pain patients at intermediate-risk for acute coronary syndrome (ACS) presenting to the emergency department (ED).
520 ## - SUMMARY, ETC.
Summary, etc. METHODS: This is a prospective two-arm clinical trial (NCT02538861) with 43 patients enrolled in stress CTP/CTA arm (General Electric Revolution CT) and 102 in SPECT-MPI arm. Mean age of the study population was 65 +/- 12 years; 56% were men. We used multivariable linear regression analysis to compare length of stay and direct costs between the two modalities.
520 ## - SUMMARY, ETC.
Summary, etc. RESULTS: Overall, 9 out of the 43 patients (21%) with CTP/CTA testing had an abnormal test. Of these 9 patients, 7 patients underwent invasive coronary angiography and 6 patients were found to have obstructive coronary artery disease. Normal CTP/CTA test was found in 34 patients (79%), who were discharged home and all patients were free of major adverse cardiac events at 30 days. The mean length of stay was significantly shorter by 28% (mean difference: 14.7 h; 95% CI: 0.7, 21) among stress CTP/CTA (20 h [IQR: 16, 37]) compared to SPECT-MPI (30 h [IQR: 19, 44.5]). Mean direct costs were significantly lower by 44% (mean difference:
-- 535; 95% CI: 987, 2082) among stress CTA/CTP (
-- 750 [IQR: 1474, 2114] compared to SPECT-MPI (
Source 837 [IQR: 2491, 3554]).
520 ## - SUMMARY, ETC.
Summary, etc. CONCLUSION: Combined stress CTP/CTA is a feasible strategy for evaluation of chest pain patients presenting to ED at intermediate-risk for ACS and has the potential to lead to shorter length of stay and lower direct costs. Copyright (c) 2020 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
546 ## - LANGUAGE NOTE
Language note English
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Topical term or geographic name entry element IN PROCESS -- NOT YET INDEXED
656 ## - INDEX TERM--OCCUPATION
Occupation Medicine
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Geographic name MedStar Union Memorial Hospital
657 ## - INDEX TERM--FUNCTION
Function Journal Article
857 ## -
-- https://dx.doi.org/10.1016/j.jcct.2020.06.195
856 ## - ELECTRONIC LOCATION AND ACCESS
Uniform Resource Identifier https://dx.doi.org/10.1016/j.jcct.2020.06.195
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection code Permanent Location Current Location Date acquired Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 2020-09-02 32807703 2020-09-02 2020-09-02 Journal Article

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