Coronary computed tomography angiography for heart team decision-making in multivessel coronary artery disease

European Heart Journal

18 October Oct 2018 one month ago
  • Andreini D, Pompilio G, Mushtaq S, Pontone, Bartorelli A

Coronary computed tomography angiography (CTA) has emerged as a non-invasive diagnostic method for patients with suspected coronary artery disease, but its usefulness in patients with complex coronary artery disease remains to be investigated.

The American and European guidelines support a heart team approach for the decision-making process regarding the revascularization strategy and recommend the evaluation of the anatomical complexity using the SYNTAX score.

Invasive coronary angiography has been the preferred diagnostic modality to assess the extent and severity of the coronary artery disease. But Technological advancements in the field of coronary computed tomography (CT) allowed for expanding its use to patients with known coronary artery disease. However, the diagnostic performance of the latest generation of CT scanners and the agreement on treatment decision in patients with multivessel coronary artery disease remains to be investigated.

The present study sought to determine the agreement between separate heart teams on treatment decision-making based on either coronary CTA or conventional angiography.

In patients with left main or three-vessel coronary artery disease, a heart team treatment decision-making based on coronary CTA showed high agreement with the decision derived from conventional coronary angiography suggesting the potential feasibility of a treatment decision-making and planning based solely on this non-invasive imaging modality and clinical information.


Reference
1. Collet C, Onuma Y, Andreini D, Sonck J, Pompilio G, Mushtaq S, La Meir M, Miyazaki Y, de Mey J, Gaemperli O, Ouda A, Maureira JP, Mandry D, Camenzind E, Macron L, Doenst T, Teichgräber U, Sigusch H, Asano T, Katagiri Y, Morel MA, Lindeboom W, Pontone G, Lüscher TF, Bartorelli AL, Serruys PW. Coronary computed tomography angiography for heart team decision-making in multivessel coronary artery disease. Eur Heart J 2018 Oct 11. doi: 10.1093/eurheartj/ehy581. [Epub ahead of print] Go to PubMed