Rief Matthias, Feger Sarah, Martus Peter, Laule Michael, Dewey Marc, Schönenberger Eva
Department of Radiology, Charité, Medical School, Berlin, Germany.
Institute for Clinical Epidemiology and Applied Biostatistics, Eberhard Karls University Tübingen, Germany.
PLoS One. 2015 Sep 1;10(9):e0136737. doi: 10.1371/journal.pone.0136737. eCollection 2015.
To evaluate how well patients with coronary stents accept combined coronary computed tomography angiography (CTA) and myocardial CT perfusion (CTP) compared with conventional coronary angiography (CCA).
While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined.
A total of 90 patients with coronary stents prospectively underwent CTA/CTP (both with contrast agent, CTP with adenosine) and CCA as part of the CARS-320 study. In this group, an intraindividual comparison of patient acceptance of CTA, CTP, and CCA was performed.
CTP was experienced to be significantly more painful than CTA (p<0.001) and was associated with a higher frequency of dyspnea (p<0.001). Comparison of CTA/CTP with CCA revealed no significant differences in terms of pain (p = 0.141) and comfort (p = 0.377). Concern before CTA/CTP and CCA and overall satisfaction were likewise not significantly different (p = 0.097 and p = 0.123, respectively). Nevertheless, about two thirds (n = 60, 68%) preferred CTA/CTP to CCA (p<0.001). Moreover, patients felt less helpless during CTA/CTP than during CCA (p = 0.026). Lack of invasiveness and absence of pain were the most frequently mentioned advantages of CTA/CTP over CCA in our patient population.
CCA and combined CTA/CTP are equally well accepted by patients; however, more patients prefer CTA/CTP. CTP was associated with more intense pain than CTA and more frequently caused dyspnea than CTA alone.
ClinicalTrials.gov NCT00967876.
评估冠状动脉支架置入患者对冠状动脉计算机断层扫描血管造影（CTA）与心肌CT灌注（CTP）联合检查的接受程度，并与传统冠状动脉造影（CCA）进行比较。
与单纯CTA相比，CTA与CTP联合检查可能提高诊断准确性，但患者对CTA/CTP的接受程度仍有待明确。
作为CARS-320研究的一部分，共有90例冠状动脉支架置入患者前瞻性地接受了CTA/CTP检查（均使用造影剂，CTP检查使用腺苷）和CCA检查。在该组患者中，对其对CTA、CTP和CCA的接受程度进行了个体内比较。
患者感觉CTP检查比CTA检查疼痛得多（p<0.001），且CTP检查出现呼吸困难的频率更高（p<0.001）。CTA/CTP与CCA在疼痛（p = 0.141）和舒适度（p = 0.377）方面无显著差异。CTA/CTP和CCA检查前的担忧程度及总体满意度同样无显著差异（分别为p = 0.097和p = 0.123）。然而，约三分之二（n = 60，68%）的患者更喜欢CTA/CTP而非CCA（p<0.001）。此外，患者在CTA/CTP检查过程中比在CCA检查过程中感觉无助感更少（p = 0.026）。在我们的患者群体中，与CCA相比，CTA/CTP最常被提及的优势是无创性和无疼痛。
患者对CCA和CTA/CTP联合检查的接受程度相当；然而，更多患者更喜欢CTA/CTP。与CTA相比，CTP检查引起的疼痛更强烈，且比单纯CTA更频繁地导致呼吸困难。
ClinicalTrials.gov NCT00967876。
