Keywords:
Multicentre study, Observational, Retrospective, Ischaemia / Infarction, Arteriosclerosis, Outcomes analysis, CAD, CT-Angiography, Cardiac
Authors:
A. Amlani, G. Benedetti, S. M. Mak, R. Preston; London/UK
DOI:
10.26044/ecr2020/C-12771
Purpose
In the UK, national guidance on the assessment of cardiac sounding chest pain (NICE CG95 2016) (1), advises that CT coronary angiography (CTCA) is the first line imaging modality.
If this reveals coronary artery disease of uncertain functional significance or is non-diagnostic, non-invasive functional testing is advised as second line. Invasive coronary angiography (ICA) is only advocated as third-line when functional imaging is inconclusive or if intervention is planned and should not be performed merely to “check” CTCA.
In addition, 45% of patients in SCOT-HEART (2) who underwent ICA following CTCA did not require percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG).
In order to try and minimise unnecessary invasive coronary angiography, we present an audit to assess the adherence to NICE guidance as well as to this 45% maximum in our centre.