CTCA Prior to Invasive Coronary Angiography in Patients With Previous Bypass Surgery: Patient-Related Outcomes, Imaging Resource Utilization, and Cardiac Events at 3 Years From the BYPASS-CTCA Trial

• DOI: 10.1161/circinterventions.124.014142
• Publication Date: 2024-11-25T10:00:27Z
• Authors: Matthew Kelham; Anne-Marie Beirne; Krishnaraj S. Rathod; Mervyn Andiapen; Lucinda Wynne; Annastazia E. Lea...; Nasim Forooghi; Rohini Ramaseshan; James C. Moon; Ceri Davies; Christos V. Boura...; Andreas Baumbach; Charlotte Manisty; Andrew Wragg; Amrita Ahluwalia; Francesca Pugliese; Anthony Mathur; Daniel A. Jones
• Keywords: 03 medical and health sciences; 0302 clinical medicine

BACKGROUND: In patients with previous coronary artery bypass grafting, computed tomography cardiac angiography (CTCA) before invasive (ICA) was demonstrated in the BYPASS-CTCA trial (Randomized Controlled Trial to Assess Whether Computed Tomography Cardiac Angiography Can Improve Invasive Coronary Bypass Surgery Patients) reduce procedure time and incidence of contrast-associated acute kidney injury, greater levels patient satisfaction. Patient-related outcomes, utilization further diagnostic imaging resources, longer-term major adverse events were key secondary end points not yet reported. METHODS: Patients prior grafting referred for ICA randomized 1:1 undergo CTCA or alone followed up a median 3 (2.2-3.4) years. Angina status assessed using Seattle Questionnaire overall quality life EQ-5D-5L. The noninvasive use compared between 2 groups. RESULTS: all, 688 randomized, 344 CTCA+ICA only. mean age participants 69.8 years, 45% undergoing syndromes remainder stable angina. At months follow-up, group more likely be angina-free (51.7% versus 43.2%; P =0.03) (EQ-5D-5L index, 81.6 74.4; =0.001), although these improvements did persist. years resource (35.8% 45.1%; odds ratio, 0.68 [95% CI, 0.50–0.92]; =0.013) lower 43.5%; hazard 0.73 0.58–0.93]; =0.010). CONCLUSIONS: ICA, leads reductions resources rate out but similar patient-related outcome measures. Together initial findings BYPASS-CTCA, data are supportive routinely undertaking grafting. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03736018.