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Background: National Institute of Clinical Excellence guidelines (NICE) recommend CT coronary angiography (CTCA) as first line investigation in patients (pts) with suspected stable angina We report our early experience with CTCA, impact on pt assessment and resource utilisation Method: A retrospective review of all pts referred for CTCA in Hauora Tairāwhiti from 1/11/18 until 31/1/ 20 Results: A total of 158 pts underwent CTCA with the indication in over 2/3rds non acute chest discomfort or exertional breathless Mean age 59 years (29-77years) 58% male, 46% NZ Māori 18% (28/158) were diabetic, 67% (107/158) hypertension 27% % (43/158) current or ex-smokers Mean LDL cholesterol was 2 6 mmol/l with 53% (83/158) on lipid lowering therapy Treadmill testing was performed in 26% (41/158), 59% (24/41) post CTCA stress echo in 16% (25/158) with the majority, 76% (19/25) performed post CTCA A 47% reduction in outpatient treadmill testing was noted from 2018 to 2019 (153 v 81) No difference was seen in stress echo (114 v 114) Limited CTCA image interpretation was available in 6 pts A Calcium score of 0 was noted in 41 pts and was predictive of the absence of atherosclerosis in all but 1 63% (99/158) had atherosclerosis with 14% (22/158) considered to have at least 1 stenosis > 50% and 8% (12/158) a focal stenosis < 50% Following CTCA 6% (9/158) were waitlisted for invasive angiography Conclusions: CTCA has impacted positively on the assessment of chest pain in Hauora Tairāwhiti with availability also influencing utility and timing of stress testing modalities
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Heart_Lung_and_Circulation
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Time to be NICE New Zealand? Evolving Chest Pain Assessment Pathways in Hauora Tairāwhiti
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