...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The American Journal of Cardiology >Three-year outcomes and cost analysis in patients receiving 64-slice computed tomographic coronary angiography for chest pain.
【24h】

Three-year outcomes and cost analysis in patients receiving 64-slice computed tomographic coronary angiography for chest pain.

机译：接受64层计算机断层扫描冠状动脉造影术治疗胸痛的患者的三年结局和费用分析。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Sixty-four slice computed tomographic coronary angiography (CTCA) is being used more often in the evaluation of patients with chest pain. The strength of this test is its high specificity and negative predictive value in exclusion of coronary artery disease (CAD). Its use remains controversial because there are theoretical risks of radiation, additional costs of the test, and no long-term data to suggest that excluding CAD by use of this test results in positive patient outcomes. A total of 436 patients underwent 64-slice CTCA because of chest pain thought to be anginal. Cardiac computed tomography was ordered by the primary physician or cardiologist based on a low to intermediate pretest probability of flow-limiting CAD. A smaller subset of patients initially underwent stress testing but had equivocal findings or continued symptoms that warranted further evaluation. Of the total patient cohort, 376 had "no significant CAD" based on computed tomographic coronary angiographic results. Of the 60 patients who were believed on computed tomographic coronary angiogram to have "flow-limiting" CAD, 34 (57%) ended up having percutaneous coronary intervention or coronary artery bypass grafting. The remaining 26 patients (43%) did not have true flow-limiting disease on coronary catheterization and were treated medically. With follow-up of 36 months, 376 of those patients (100%) with minimal or no disease by CTCA were free of events or intervention. In conclusion, in a real-world, clinical setting, the negative predictive value of low-risk CTCA is very high and exceptionally helpful in predicting freedom from events for up to 3 years. By avoiding further invasive treatments, there is a significant potential cost savings in patients who are sent for noninvasive coronary angiography rather than invasive angiography.
机译：在评估胸痛患者中，越来越多地使用64层计算机断层扫描冠状动脉造影（CTCA）。该测试的优势在于其高特异性和排除冠状动脉疾病（CAD）的阴性预测价值。它的使用仍存在争议，因为存在放射线的理论风险，测试的额外费用，并且没有长期数据表明使用此测试排除CAD会带来积极的患者结果。由于认为是心绞痛的胸痛，共有436例患者接受了64层CTCA检查。初级医师或心脏病专家根据流量受限CAD的中低预测试概率下令进行心脏计算机断层扫描。一小部分患者最初接受了压力测试，但模棱两可的发现或持续的症状值得进一步评估。基于计算机断层扫描冠状动脉造影结果，在全部患者队列中，有376名患者“无明显CAD”。在计算机断层扫描冠状动脉造影上被认为具有“限流” CAD的60位患者中，有34位（57％）最终接受了经皮冠状动脉介入治疗或冠状动脉搭桥术。其余26名患者（43％）在进行冠状动脉插管术时没有真正的限流疾病，并接受了药物治疗。经过36个月的随访，CTCA病情极少或无疾病的患者中有376例（100％）没有任何事件或干预。总而言之，在现实的临床环境中，低风险CTCA的阴性预测价值非常高，并且在预测长达3年的事件自由度方面尤其有帮助。通过避免进一步的侵入性治疗，对于非侵入性冠状动脉造影而不是侵入性血管造影的患者，可以节省大量的潜在成本。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号