Computed tomography coronary angiography vs. standard diagnostic procedure for the diagnosis of angina due to coronary heart disease: A cross‑sectional study

Wu,Zheng; He,Yi; Li,Wenzheng; Cheng,Shujuan

doi:10.3892/etm.2019.7229

Computed tomography coronary angiography vs. standard diagnostic procedure for the diagnosis of angina due to coronary heart disease: A cross‑sectional study

Authors:
- Zheng Wu
- Yi He
- Wenzheng Li
- Shujuan Cheng
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Affiliations: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, P.R. China, Department of Radiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, P.R. China
Published online on: January 31, 2019 https://doi.org/10.3892/etm.2019.7229
Pages: 2485-2494
Copyright: © Wu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Patients with episodes of angina are likely to experience future cardiac events and benefit from a revascularization procedure. Conventional invasive coronary angiography is a well‑established and reliable method for the detection of angina, but it has a risk of complications and false‑negative diagnosis. The objective of the present study was to assess the utility of computed tomography coronary angiography (CTCA) in the diagnosis of angina due to coronary heart disease. A total of 2,426 patients with chest pain referred to the rapid access chest pain clinic of Beijing Anzhen Hospital, Capital Medical University (Beijing, P.R. China) between 18 January 2016 and 1 December 2017 were included in the present cross‑sectional study. All patients were subjected to evaluation of symptoms, blood tests, 12‑lead electrocardiogram (ECG), exercise ECG, coronary artery calcium scoring and CTCA. The cost of the diagnosis of angina was determined for each individual method. In total, 776 (32%) and 1,420 (58%) of patients were identified to be abnormal on clinical assessment and CTCA, respectively. Exercise ECG results were not correlated with the interpretation of CTCA (r=0.8511). The working area of the angina due to coronary heart disease detected at one time by the different diagnostic procedures was in the order of ECG <clinical assessment <exercise ECG <coronary artery calcium scoring <CTCA. The cost of the ‘standard diagnostic procedure (clinical assessments, ECG, exercise ECG)' was 15,452±806 ¥/patient and that of CTCA was 12,546±612 ¥/patient. CTCA had a higher sensitivity for the diagnosis of angina due to coronary heart disease and the cost was lower than that of the ‘standard diagnostic procedure’ (level of evidence: 3). The current study was registered at the Research Registry on 11th January 2016 (trial no. researchregistry4232).

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