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General practice preventive health care in non-obstructive coronary artery disease determined by coronary computed tomography angiography.

Abstract：

BACKGROUND:The aim of this study was to compare changes in health service utilization, preventive medical management, and cholesterol levels in patients without coronary artery disease (CAD) or with non-obstructive CAD as determined by coronary computed tomography angiography (CTA). METHODS:Single-center five-year observational registry-based cohort study of consecutive patients with chest pain undergoing coronary CTA with subsequent 12 months follow-up in general practice. RESULTS:We included 3032 patients with a normal test result (n = 2179) or a diagnosis of non-obstructive CAD (n = 853) by coronary CTA. Median age was 55 (interquartile range: 47-63) years and 44% were males. After coronary CTA, the probability of a decrease in consultations with general practitioner was higher in patients with no CAD compared to patients with non-obstructive CAD (adjusted OR = 0.81 [95% CI: 0.68-0.96], P = 0.016). Accordingly, patients with non-obstructive CAD more frequently received prescriptions on lipid-lowering medical therapy (adjusted OR = 4.50 [95% CI: 3.31-6.12], P < 0.001) than patients with no CAD after coronary CTA. In patients with non-obstructive CAD, mean total-cholesterol reduction was 0.51 (P < 0.001) compared to 0.13 mmol/L (P < 0.001) in patients without non-obstructive CAD. The relative reduction in low-density lipoprotein was 14% higher (P < 0.001) in patients with compared to patients without non-obstructive CAD after coronary CTA. CONCLUSIONS:Coronary CTA with subsequent follow-up in general practice has the potential to align health service utilization that prioritizes high-risk patients and facilitate optimized preventive management.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Mols RE,Nørgaard BL,Vedsted P,Farkas DK,Bøtker HE,Jensen JM

doi

10.1016/j.ijcard.2018.09.094

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

14-21

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(17)37105-X

journal_volume

278

pub_type

杂志文章

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