Selective Referral Using CCTA Versus Direct Referral for Individuals Referred to Invasive Coronary Angiography for Suspected CAD A Randomized, Controlled, Open-Label Trial
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Chang, Hyuk-Jae | - |
dc.contributor.author | Lin, Fay Y. | - |
dc.contributor.author | Gebow, Dan | - |
dc.contributor.author | An, Hae Young | - |
dc.contributor.author | Andreini, Daniele | - |
dc.contributor.author | Bathina, Ravi | - |
dc.contributor.author | Baggiano, Andrea | - |
dc.contributor.author | Beltrama, Virginia | - |
dc.contributor.author | Cerci, Rodrigo | - |
dc.contributor.author | Choi, Eui-Young | - |
dc.contributor.author | Choi, Jung-Hyun | - |
dc.contributor.author | Choi, So-Yeon | - |
dc.contributor.author | Chung, Namsik | - |
dc.contributor.author | Cole, Jason | - |
dc.contributor.author | Doh, Joon-Hyung | - |
dc.contributor.author | Ha, Sang-Jin | - |
dc.contributor.author | Her, Ae-Young | - |
dc.contributor.author | Kepka, Cezary | - |
dc.contributor.author | Kim, Jang-Young | - |
dc.contributor.author | Kim, Jin-Won | - |
dc.contributor.author | Kim, Sang-Wook | - |
dc.contributor.author | Kim, Woong | - |
dc.contributor.author | Pontone, Gianluca | - |
dc.contributor.author | Valeti, Uma | - |
dc.contributor.author | Villines, Todd C. | - |
dc.contributor.author | Lu, Yao | - |
dc.contributor.author | Kumar, Amit | - |
dc.contributor.author | Cho, Iksung | - |
dc.contributor.author | Danad, Ibrahim | - |
dc.contributor.author | Han, Donghee | - |
dc.contributor.author | Heo, Ran | - |
dc.contributor.author | Lee, Sang-Eun | - |
dc.contributor.author | Lee, Ji Hyun | - |
dc.contributor.author | Park, Hyung-Bok | - |
dc.contributor.author | Sung, Ji-min | - |
dc.contributor.author | Leflang, David | - |
dc.contributor.author | Zullo, Joseph | - |
dc.contributor.author | Shaw, Leslee J. | - |
dc.contributor.author | Min, James K. | - |
dc.date.available | 2020-11-02T06:35:18Z | - |
dc.date.issued | 2019-07 | - |
dc.identifier.issn | 1936-878X | - |
dc.identifier.issn | 1876-7591 | - |
dc.identifier.uri | https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1853 | - |
dc.description.abstract | Objectives This study compared the safety and diagnostic yield of a selective referral strategy using coronary computed tomographic angiography (CCTA) compared with a direct referral strategy using invasive coronary angiography (ICA) as the index procedure. Background Among patients presenting with signs and symptoms suggestive of coronary artery disease (CAD), a sizeable proportion who are referred to ICA do not have a significant, obstructive stenosis. Methods In a multinational, randomized clinical trial of patients referred to ICA for nonemergent indications, a selective referral strategy was compared with a direct referral strategy. The primary endpoint was noninferiority with a multiplicative margin of 1.33 of composite major adverse cardiovascular events (blindly adjudicated death, myocardial infarction, unstable angina, stroke, urgent and/or emergent coronary revascularization or cardiac hospitalization) at a median follow-up of 1-year. Results At 22 sites, 823 subjects were randomized to a selective referral and 808 to a direct referral strategy. At 1 year, selective referral met the noninferiority margin of 1.33 (p = 0.026) with a similar event rate between the randomized arms of the trial (4.6% vs. 4.6%; hazard ratio: 0.99; 95% confidence interval: 0.66 to 1.47). Following CCTA, only 23% of the selective referral arm went on to ICA, which was a rate lower than that of the direct referral strategy. Coronary revascularization occurred less often in the selective referral group compared with the direct referral to ICA (13% vs. 18%; p < 0.001). Rates of normal ICA were 24.6% in the selective referral arm compared with 61.1% in the direct referral arm of the trial (p < 0.001). Conclusions In stable patients with suspected CAD who are eligible for ICA, the comparable 1-year major adverse cardiovascular events rates following a selective referral and direct referral strategy suggests that both diagnostic approaches are similarly effective. In the selective referral strategy, the reduced use of ICA was associated with a greater diagnostic yield, which supported the usefulness of CCTA as an efficient and accurate method to guide decisions of ICA performance. (Coronary Computed Tomographic Angiography for Selective Cardiac Catheterization [CONSERVE]; NCT01810198) | - |
dc.format.extent | 10 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | Elsevier BV | - |
dc.title | Selective Referral Using CCTA Versus Direct Referral for Individuals Referred to Invasive Coronary Angiography for Suspected CAD A Randomized, Controlled, Open-Label Trial | - |
dc.type | Article | - |
dc.publisher.location | 미국 | - |
dc.identifier.doi | 10.1016/j.jcmg.2018.09.018 | - |
dc.identifier.scopusid | 2-s2.0-85067505210 | - |
dc.identifier.wosid | 000473333400001 | - |
dc.identifier.bibliographicCitation | JACC: Cardiovascular Imaging, v.12, no.7, pp 1303 - 1312 | - |
dc.citation.title | JACC: Cardiovascular Imaging | - |
dc.citation.volume | 12 | - |
dc.citation.number | 7 | - |
dc.citation.startPage | 1303 | - |
dc.citation.endPage | 1312 | - |
dc.type.docType | Article | - |
dc.description.isOpenAccess | N | - |
dc.description.journalRegisteredClass | sci | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalResearchArea | Radiology, Nuclear Medicine & Medical Imaging | - |
dc.relation.journalWebOfScienceCategory | Cardiac & Cardiovascular Systems | - |
dc.relation.journalWebOfScienceCategory | Radiology, Nuclear Medicine & Medical Imaging | - |
dc.subject.keywordPlus | COMPUTED-TOMOGRAPHY ANGIOGRAPHY | - |
dc.subject.keywordPlus | AMERICAN-HEART-ASSOCIATION | - |
dc.subject.keywordPlus | DIAGNOSTIC PERFORMANCE | - |
dc.subject.keywordPlus | ARTERY-DISEASE | - |
dc.subject.keywordPlus | TASK-FORCE | - |
dc.subject.keywordPlus | EXPOSURE | - |
dc.subject.keywordPlus | CATHETERIZATION | - |
dc.subject.keywordPlus | GUIDELINES | - |
dc.subject.keywordPlus | CARDIOLOGY | - |
dc.subject.keywordPlus | RADIATION | - |
dc.subject.keywordAuthor | coronary computed tomographic angiography | - |
dc.subject.keywordAuthor | invasive coronary angiography | - |
dc.subject.keywordAuthor | major adverse cardiac events | - |
dc.subject.keywordAuthor | stable ischemic heart disease | - |
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.
73, Goryeodae-ro, Seongbuk-gu, Seoul, Republic of Korea (02841)82-2-2286-1265
COPYRIGHT 2020 KOREA UNIVERSITY MEDICAL LIBRARY ALL RIGHTS RESERVED.
Certain data included herein are derived from the © Web of Science of Clarivate Analytics. All rights reserved.
You may not copy or re-distribute this material in whole or in part without the prior written consent of Clarivate Analytics.