Circ Cardiovasc Imaging. 2014 Jul;7(4):629-38 doi: 10.1161/CIRCIMAGING.113.001564. 2014 Jun 06.

Coronary artery disease detected by coronary computed tomographic angiography is associated with intensification of preventive medical therapy and lower low-density lipoprotein cholesterol

Hulten E, Bittencourt MS, Singh A, O'Leary D, Christman MP, Osmani W, Abbara S, Steigner ML, Truong QA, Nasir K, Rybicki FF, Klein J, Hainer J, Brady TJ, Hoffmann U, Ghoshhajra BB, Hachamovitch R, Di Carli MF, Blankstein R.


BACKGROUND: Coronary computed tomographic angiography (CCTA) is an accurate test for the identification of coronary artery disease (CAD), yet the impact of CCTA results on subsequent medical therapy and risk factors has not been widely reported.
METHODS AND RESULTS: We identified consecutive patients aged >18 years without prior CAD who underwent CCTA from 2004 to 2011 and had complete data on medications before and after CCTA. CCTA results were categorized as no CAD, 4 segments). Electronic medical records and patient interviews were reviewed blinded to CCTA findings to assess initiation of aspirin and intensification of lipid-lowering therapies. Survival analysis was performed to evaluate intensification of lipid therapy as a predictor of cardiovascular death or nonfatal myocardial infarction. Among 2839 patients with mean follow-up of 3.6 years, the odds of physician intensification of lipid-lowering therapy significantly increased for those with nonobstructive CAD (odds ratio, 3.6; 95% confidence interval, 2.9-4.9; P CONCLUSIONS: Abnormal CCTA findings are associated with downstream intensification in statin and aspirin therapy. In particular, CCTA may lead to increased use of prognostically beneficial therapies in patients identified as having extensive, nonobstructive CAD.

PMID: 24906356