CT Angiography Versus Routine Stress Testing for Patients with Chest Pain Seen in the Emergency Room to Exclude Significant Coronary Artery Disease

2015 ◽  
pp. 83-98
Author(s):  
Gaston A. Rodriguez-Granillo ◽  
Patricia Carrascosa
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Emergency Room ◽  
Ct Angiography ◽  
Stress Testing ◽  
Significant Coronary Artery Disease ◽  
Artery Disease

scholarly journals Downstream procedures and outcomes after stress testing for chest pain without known coronary artery disease in the United States

2012 ◽  
Vol 163 (3) ◽  
pp. 454-461 ◽  
Author(s):  
Daniel W. Mudrick ◽  
Patricia A. Cowper ◽  
Bimal R. Shah ◽  
Manesh R. Patel ◽  
Neil C. Jensen ◽  
...  
Keyword(s):  
United States ◽  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Stress Testing ◽  
The United States ◽  
Artery Disease

scholarly journals Subtraction CT angiography improves evaluation of significant coronary artery disease in patients with severe calcifications or stents—the C-Sub 320 multicenter trial

2018 ◽  
Vol 28 (10) ◽  
pp. 4077-4085 ◽  
Author(s):  
Andreas Fuchs ◽  
J. Tobias Kühl ◽  
Marcus Y. Chen ◽  
David Viladés Medel ◽  
Xavier Alomar ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ct Angiography ◽  
Significant Coronary Artery Disease ◽  
Multicenter Trial ◽  
Artery Disease

scholarly journals Relationship of Stress Test Findings to Anatomic or Functional Extent of Coronary Artery Disease Assessed by Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Demetrios Doukas ◽  
Sorcha Allen ◽  
Amy Wozniak ◽  
Siri Kunchakarra ◽  
Rina Verma ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Stress Testing ◽  
Stress Test ◽  
Exercise Duration ◽  
Fractional Flow ◽  
Coronary Cta ◽  
Flow Reserve ◽  
Artery Disease

Background. In the United States, functional stress testing is the primary imaging modality for patients with stable symptoms suspected to represent coronary artery disease (CAD). Coronary computed tomography angiography (CTA) is excellent at identifying anatomic coronary artery disease (CAD). The application of computational fluid dynamics to coronary CTA allows fractional flow reserve (FFR) to be calculated noninvasively (FFRCT). The relationship of noninvasive stress testing to coronary CTA and FFRCT in real-world clinical practice has not been studied. Methods. We evaluated 206 consecutive patients at Loyola University Chicago with suspected CAD who underwent noninvasive stress testing followed by coronary CTA and FFRCT when indicated. Patients were categorized by stress test results (positive, negative, indeterminate, and equivocal). Duke treadmill score (DTS), METS, exercise duration, and chest pain with exercise were analyzed. Lesions ≥ 50 % stenosis were considered positive by coronary CTA. FF R CT < 0.80 was considered diagnostic of ischemia. Results. Two hundred and six patients had paired noninvasive stress test and coronary CTA/FFRCT results. The median time from stress test to coronary CTA was 49 days. Average patient age was 60.3 years, and 42% were male. Of the 206 stress tests, 75% were exercise (70% echocardiographic, 26% nuclear, and 4% EKG). There were no associations of stress test results with CAD > 50 % or FF R CT < 0.80 ( p = 0.927 and p = 0.910 , respectively). Of those with a positive stress test, only 30% (3/10) had CAD > 50 % and only 50% (5/10) had FF R CT < 0.80 . Chest pain with exercise did not correlate with CAD > 50 % or FF R CT < 0.80 ( p = 0.66 and p = 0.12 , respectively). There were no significant correlations between METS, DTS, or exercise duration and FFRCT ( r = 0.093 , p = 0.274 ; r = 0.012 , p = 0.883 ; and r = 0.034 , p = 0.680 ; respectively). Conclusion. Noninvasive stress testing, functional capacity, chest pain with exercise, and DTS are not associated with anatomic or functional CAD using a diagnostic strategy of coronary CTA and FFRCT.

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