Acceptance of Combined Coronary CT Angiography and Myocardial CT Perfusion versus Conventional Coronary Angiography in Patients with Coronary Stents--Intraindividual Comparison

PLoS One. 2015 Sep 1;10(9):e0136737. doi: 10.1371/journal.pone.0136737. eCollection 2015.

Abstract

Objectives: To evaluate how well patients with coronary stents accept combined coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) compared with conventional 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 contrast 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 associated 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). Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Vessel Prosthesis*
  • Coronary Angiography / psychology*
  • Coronary Disease / diagnosis
  • Coronary Disease / diagnostic imaging
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Perfusion Imaging / psychology*
  • Pain / etiology
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Preference / psychology
  • Patient Satisfaction / statistics & numerical data
  • Stents*
  • Surveys and Questionnaires
  • Tomography, X-Ray Computed / psychology

Associated data

  • ClinicalTrials.gov/NCT00967876

Grants and funding

The CARS-320 study was supported by a grant from BRACCO. The authors of this manuscript declare relationships with the following companies: Prof. Dewey has received grant support from the Heisenberg Program of the DFG for a professorship (DE 1361/14-1), the FP7 Program of the European Commission for the randomized multicenter DISCHARGE trial (603266-2, HEALTH-2012.2.4.-2), the European Regional Development Fund (20072013 2/05, 20072013 2/48), the German Heart Foundation/German Foundation of Heart Research (F/23/08, F/27/10), the Joint Program from the German Research Foundation (DFG) and the German Federal Ministry of Education and Research (BMBF) for meta-analyses (01KG1013, 01KG1110, 01KG1110), GE Healthcare, and Bracco, Guerbet, and Toshiba Medical Systems. The CARS-320 study has received grants from Bracco. Prof. Dewey has received lecture fees from Toshiba Medical Systems, Guerbet, Cardiac MR Academy Berlin, and Bayer (Schering-Berlex). Prof. Dewey is a consultant to Guerbet and one of the principal investigators of multi-center studies (CORE-64 and 320) on coronary CT angiography sponsored by Toshiba Medical Systems. He is the editor of Coronary CT Angiography and Cardiac CT, both published by Springer. He also offers hands-on workshops on cardiovascular imaging (www.ct-kurs.de), and is an associate editor of Radiology and European Radiology. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.