Computed tomography coronography is a non-invasive medical examination that takes pictures of the moving heart and large vessels. She diagnoses coronary artery disease (heart disease) and myocardial infarction.
Although computed tomography coronary angiography (CTA) improves diagnostic certainty in the evaluation of patients with chest pain, its effect on clinical outcomes at 5 years has been unknown until now.
To address this lack of data, the researchers randomly assigned 4,146 chest pain patients to standard care plus ACT (2073 patients) or standard care alone (2073 patients). Clinical results were analyzed over a period of 3 to 7 years. The primary endpoint was death from coronary heart disease or myocardial infarction.
Images of the moving heart and the great vessels
Invasive coronary angiography is the gold standard for the anatomical exploration of the coronary arteries. It involves puncturing an artery and is currently the most performed hospital procedure in Western countries in patients over 65 years of age. More than one million procedures have been done in the United States since 1993. In France, in 2007, 260,000 coronary angiograms were performed, resulting in 120,000 coronary angioplasties, 45% of which involved the placement of active stents.
Non-invasive, computed tomography coronography can take pictures of the heart in motion and large vessels.
Use of ACT in addition to standard care
“In this trial, the use of ACT in addition to standard care in patients with stable chest pain resulted in a death rate from coronary artery disease or myocardial infarction significantly lower than that of standard care alone, without leading to a significantly higher rate of coronary angiography or coronary revascularization (1) “, indicate the authors.
Although the rates of invasive coronary angiography and coronary revascularization were higher in the ACT group than in the standard care group during the first months of follow-up, the overall rates were similar at 5 years. Invasive coronary angiography was performed in 491 patients in the CTA group and in 502 patients in the standard care group. Coronary revascularization was performed in 279 patients in the CTA group and in 267 patients in the standard care group. However, more preventive treatments were started in patients in the ACT group, as well as more antianginal treatments (2).
1) The revascularization of the heart muscle (myocardium) defines all the therapeutic procedures which, by restoring a satisfactory flow in the nourishing arteries of the heart – the coronary arteries – aim to restore the oxygen supply to the heart muscle.
2) Medication used in the treatment of coronary insufficiency (lack of irrigation of the heart muscle by the arteries coronary).
.