Lower death rate from coronary heart disease, non-fatal MI at 5 yr in patients with stable chest pain
WEDNESDAY, Sept. 5, 2018 (HealthDay News) — For patients with stable chest pain, coronary computed tomographic angiography (CTA) results in a lower rate of death from coronary heart disease or non-fatal myocardial infarction at five years, according to a study published in the Sept. 6 issue of the New England Journal of Medicine.
David E. Newby, M.D., from the University of Edinburgh in the United Kingdom, and colleagues randomized 4,146 patients with stable chest pain who had been referred to a cardiology clinic for evaluation to either standard care plus CTA or standard care alone in a 1:1 ratio. Patients were followed for a median of 4.8 years, with 20,254 patient-years of follow-up.
The researchers found that the five-year rate of the primary end point (death from coronary heart disease or non-fatal myocardial infarction at five years) was lower in the CTA versus the standard-care group (2.3 versus 3.9 percent; hazard ratio, 0.59). In the first few months of follow-up, the rates of invasive coronary angiography and coronary revascularization were higher in the CTA group; however, overall rates were similar at five years. More preventive therapies and antianginal therapies were initiated in patients in the CTA group (odds ratios, 1.40 and 1.27, respectively).
“The use of CTA in addition to standard care in patients with stable chest pain resulted in a significantly lower rate of death from coronary heart disease or non-fatal myocardial infarction at five years than standard care alone,” the authors write.
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