Coronary computed tomography angiography (CTA) screening for coronary artery disease
(CAD) is an indispensable diagnostic tool in clinical practice because of its excellent
negative predictive value and ability to exclude critical CAD. Recently, there has
been increasing interest amongst clinicians and researchers in understanding the prognostic
impact of coronary CTA on improving clinical outcomes and, to this end, three randomized
controlled trials (RCTs): PROMISE [
[1]
], SCOT-HEART [
[2]
], and DISCHARGE [
[3]
], have been conducted to date. PROMISE demonstrated that CTA-based strategies did
not improve clinical outcomes above strategies that emphasize functional testing [
[1]
]. In contrast, SCOT-HEART showed that patients experienced improved prognoses when
CTA was added onto the standard care group diagnostic regimen [
[2]
]. In DISCHARGE, there were no significant differences in patient prognoses between
CTA and invasive coronary angiography (ICA) treatment groups [
[3]
]. However, an analysis of each subgroup suggests that implementation of a CTA-based
strategy may improve the outcomes of diabetic patients at higher risk of CAD [
2
,
3
,
4
]. Therefore, to explore this hypothesis, we performed a meta-analysis to determine
whether CTA implementation improves clinical outcomes in patients with diabetes mellitus
(DM).To read this article in full you will need to make a payment
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References
- Outcomes of anatomical versus functional testing for coronary artery disease.N Engl J Med. 2015; 372: 1291-1300
- Coronary CT angiography and 5-year risk of myocardial infarction.N Engl J Med. 2018; 379: 924-933
- CT or invasive coronary angiography in stable chest pain.N Engl J Med. 2022; 386: 1591-1602
- Stress testing versus CT angiography in patients with diabetes and suspected coronary artery disease.J Am Coll Cardiol. 2019; 73: 893-902
Article info
Publication history
Published online: August 27, 2022
Accepted:
August 22,
2022
Received:
August 10,
2022
Identification
Copyright
© 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
