Use of CCTA Screening Tied to Increased Invasive Testing

Coronary computed tomographic angiography tied to elevated medication use and revascularizations

TUESDAY, May 24 (HealthDay News) -- Low-risk adults who undergo coronary computed tomographic angiography (CCTA) screening use more medications and undergo invasive coronary procedures, according to a study published online May 23 in Archives of Internal Medicine.

John W. McEvoy, M.B.B.Ch., from the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore, and colleagues examined the impact of CCTA results on physician and patient behavior in a population of 1,000 asymptomatic patients selected from a health screening program. Participants who underwent CCTA were matched with a control group of 1,000 patients who did not undergo the procedure. Use of medications, secondary test referrals, revascularizations, and cardiovascular events at 90 days and 18 months were evaluated.

The investigators found that 215 patients in the CCTA group were CCTA positive and had coronary atherosclerosis. Aspirin and statin use were higher in the CCTA-positive group compared to CCTA-negative and control groups at both 90 days and the 18-month follow-up. In the CCTA-positive group, use of statin and aspirin increased at 18 months (odds ratio, 3.3 and 4.2, respectively) after adjusting for confounders. Patients in the CCTA group were significantly more likely to have secondary tests and revascularizations at 90 days compared to controls. In each group, there was only one major cardiovascular event over 18 months.

"An abnormal screening CCTA result was predictive of increased aspirin and statin use at 90 days and 18 months," the authors write. "Screening CCTA was associated with increased invasive testing, without any difference in events at 18 months. Screening CCTA should not be considered a justifiable test at this time,"

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