ArticleJACC. Cardiovascular imaging2020
Preventive Management of Nonobstructive CAD After Coronary CT Angiography in the Emergency Department.
Article in JACC. Cardiovascular imaging, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- 2022 ACC Expert Consensus Decision Pathway on the Evaluation and Disposition of Acute Chest Pain in the Emergency Department: A Report of the American College of Cardiology Solution Set Oversight Committee.Journal of the American College of Cardiology · 2022Guideline
- SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography.Journal of cardiovascular computed tomographyGuideline
- The utilization of myocardial perfusion imaging prior to coronary angiography to improve outcomes and cost-effectiveness of patients with stable coronary artery disease: a comparative cohort study in China.BMC medical imaging · 2026Article
- From image to action: Evaluating the translation of coronary CT angiography findings into cardiovascular prevention in the emergency department.American journal of preventive cardiology · 2026Article
- Prognostic implications of left ventricular mass-geometry in patients with no or nonobstructive coronary artery disease.BMC cardiovascular disorders · 2021Observational
- Use of Preventive Medications in Patients With Nonobstructive Coronary Artery Disease: Analysis of the PROMISE Trial.CJC open · 2021Article
- Machine Learning CT FFR: The Evolving Role of On-Site Techniques.Radiology. Cardiothoracic imaging · 2020Article
- IL-6-targeted ultrasmall superparamagnetic iron oxide nanoparticles for optimized MRI detection of atherosclerotic vulnerable plaques in rabbits.RSC advances · 2020Article
- Use of cardiac CT amidst the COVID-19 pandemic and beyond: North American perspective.Journal of cardiovascular computed tomographyReview
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Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesThis study sought to assess medical management of patients found to have nonobstructive coronary artery disease (CAD) on coronary computed tomography angiography (CCTA) performed in the emergency department (ED).
backgroundContemporary recognition and management of nonobstructive CAD discovered on CCTA performed in the ED is unknown.
methodsPatients undergoing CCTA in the authors' hospital's ED between November 2013 and March 2018 who also received primary care within the authors' health system were studied. All patients with nonobstructive CAD, defined as 1% to 49% maximum luminal stenosis on CCTA, were included, along with a control group without CAD in a 1 case:1 control fashion. Ten-year atherosclerotic cardiovascular disease (ASCVD) risk prior to CCTA was estimated using the Pooled Cohort Equations. Management changes were recorded until 6 months after CCTA. Multivariate logistic regression tested the association between CCTA result and follow-up statin prescription, adjusting for cardiovascular risk factors and baseline statin use.
resultsThe cohort included 510 patients with nonobstructive CAD and 510 controls. Prevalence of statin prescription increased from 38.8% to 56.1% among patients with nonobstructive CAD (p < 0.001) and 18.0% to 20.4% among controls (p = 0.01), representing a 7.1-fold relative difference (95% confidence interval [CI]: 4.4 to 23.0; p < 0.001) in multivariate analysis. However, 30.0% of patients with nonobstructive CAD and ≥20% 10-year ASCVD risk were not prescribed a statin at the end of follow-up. Cardiologist evaluation was independently associated with statin prescription after adjustment for ASCVD risk factors (odds ratio [OR] 4.4; 95% CI: 2.4 to 8.5; p < 0.001). A Coronary Artery Disease Reporting and Data System class 1 to 2 result was associated with lower low-density lipoprotein cholesterol by 12.1 mg/dl at mean 1.9-year follow-up (p < 0.001).
conclusionsIncidental subclinical atherosclerosis on CCTA performed in the ED increases the likelihood of statin prescription, but opportunities to improve allocation of indicated preventive therapies remain.
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