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A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
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20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
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26. Cardiovascular Surgery
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28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
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A meta-analysis of coronary CT Angiography for predicting long-term major adverse cardiac events in stable coronary artery disease
Session:
Posters - B. Imaging
Speaker:
Diana De Campos
Congress:
CPC 2021
Topic:
B. Imaging
Theme:
03. Imaging
Subtheme:
03.2 Computed Tomography
Session Type:
Posters
FP Number:
---
Authors:
Diana Decampos; Rogério Teixeira; Carolina Saleiro; João Lopes; Lino Gonçalves
Abstract
<p>Background: Coronary computed tomography angiography (CCTA) was shown to be superior to functional testing (FT) in patients in terms of reducing nonfatal myocardial infarction (MI) in short-term follow-up of acute and stable suspected stable coronary artery disease (CAD). However, the impact of CCTA as the initial strategy on long-term outcomes in stable CAD has not been established.</p> <p> </p> <p>Methods: We conducted a meta-analysis to compare the outcomes of CCTA versus FT on stable CAD. We searched databases for studies that reported clinical outcomes following CCTA or FT, with a follow-up of at least 12 months.</p> <p> </p> <p>Results: Eight studies enrolling 29,579 patients were included. A total of 14,457 patients underwent CCTA and 15,122 patients performed a FT. CCTA outperformed FT in terms of nonfatal MI, with a reduction of its risk (risk ratio: 0.59, 95% confidence interval [CI]: 0.41-0.83, P = 0.003). There was a trend for reduced composite endpoint of all-cause death and nonfatal ACS following initial CCTA strategy. Compared with FT, the initial CCTA strategy reduced long-term use of downstream testing, including ICA; but increased the use of coronary revascularization during the first year of follow-up (odds ratio: 1.72; 95%CI 1.11-2.66; P=0.01).</p> <p> </p> <p>Conclusions: In stable CAD, CCTA distinctly improved reduced nonfatal MI and long-term use of downstream testing, including ICA. Tradeoffs include more frequent use of coronary revascularization procedures during the first year of follow-up.</p>
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