Acceptance of combined coronary CT angiography and myocardial CT perfusion versus conventional coronary angiography in patients with coronary stents-intraindividual comparison

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Abstract

Objectives To evaluate how well patients with coronary stents accept combined coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) compared with con- ventional coronary angiography (CCA). Background While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined. Methods A total of 90 patients with coronary stents prospectively underwent CTA/CTP (both with con- trast agent, CTP with adenosine) and CCA as part of the CARS-320 study. In this group, an intraindividual comparison of patient acceptance of CTA, CTP, and CCA was performed. Results CTP was experienced to be significantly more painful than CTA (p<0.001) and was associ- ated with a higher frequency of dyspnea (p<0.001). Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377). Con- cern before CTA/CTP and CCA and overall satisfaction were likewise not significantly differ- ent (p = 0.097 and p = 0.123, respectively). Nevertheless, about two thirds (n = 60, 68%) preferred CTA/CTP to CCA (p<0.001).Moreover, patients felt less helpless during CTA/ CTP than during CCA (p = 0.026). Lack of invasiveness and absence of pain were the most frequently mentioned advantages of CTA/CTP over CCA in our patient population. Conclusions CCA and combined CTA/CTP are equally well accepted by patients; however, more patients prefer CTA/CTP. CTP was associated with more intense pain than CTA and more frequently caused dyspnea than CTA alone. Trial Registration ClinicalTrials.gov NCT00967876

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Rief, M., Feger, S., Martus, P., Laule, M., Dewey, M., & Schönenberger, E. (2015). Acceptance of combined coronary CT angiography and myocardial CT perfusion versus conventional coronary angiography in patients with coronary stents-intraindividual comparison. PLoS ONE, 10(9). https://doi.org/10.1371/journal.pone.0136737

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