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与一般人群相比,CT 血管造影前后疑似慢性冠状动脉综合征患者与全科医生的接触情况。

Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population.

机构信息

D epartment of Cardiology, Gødstrup Hospital, Hospitalsparken 15, DK-7400, Herning, Denmark.

Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Eur Heart J Qual Care Clin Outcomes. 2024 Nov 5;10(7):623-631. doi: 10.1093/ehjqcco/qcad074.

Abstract

BACKGROUND

Most patients undergoing coronary computed tomography angiography (CCTA) to diagnose coronary artery disease (CAD) are referred from general practitioners (GPs). The burden of contacts to GP in relation to investigation of suspected CAD is unknown.

METHODS AND RESULTS

All patients undergoing CCTA in Western Denmark from 2014 to 2022 were included. CCTA stenosis was defined as diameter stenosis of ≥50%. Patients with and without stenosis were matched, in each group, 1:5 to a reference population based on birth year, gender, and municipality using data from national registries. All GP visits were registered up to 5 years preceding and 1 year after the CTA and stratified by gender and age. Charlson comorbidity index (CCI) was calculated in all groups.Of the 62 512 patients included, 12 886 had a stenosis, while 49 626 did not. Patients in both groups had a substantially higher GP visit frequency compared with reference populations. In the year of coronary CTA, the median GP contacts in patients with stenosis were 11 (6-17) vs. 6 (2-11) in the reference population (P < 0.001), and in patients without stenosis, the median GP contacts were 10 (6-17) vs. 5 (2-11) (P < 0.001). These findings were consistent across age and gender. CCI was higher among both patients with and without stenosis compared with reference groups.

CONCLUSION

In patients undergoing CCTA to diagnose CAD, a substantially increased frequency of contacts to GP was observed in the 5-year period prior to examination compared with the reference populations, regardless of the CCTA findings. Obtaining the CCTA result did not seem to substantially affect the GP visit frequency.

摘要

背景

大多数因疑似冠心病(CAD)而行冠状动脉计算机断层扫描血管造影(CCTA)检查的患者均由全科医生(GP)转诊。目前尚不清楚与疑似 CAD 调查相关的 GP 接触次数的负担。

方法和结果

纳入了 2014 年至 2022 年在丹麦西部接受 CCTA 的所有患者。CCTA 狭窄定义为直径狭窄≥50%。在每组中,根据出生年份、性别和市,使用国家登记处的数据,对有和无狭窄的患者进行 1:5 匹配,以建立参考人群。在 CCTA 之前的 5 年和之后的 1 年,对所有 GP 就诊进行了登记,并按性别和年龄进行了分层。在所有组中计算了 Charlson 合并症指数(CCI)。在纳入的 62512 例患者中,有 12886 例有狭窄,而 49626 例没有狭窄。与参考人群相比,两组患者的 GP 就诊频率均明显较高。在接受冠状动脉 CCTA 的那一年,狭窄患者的中位数 GP 就诊次数为 11(6-17),而参考人群为 6(2-11)(P<0.001),无狭窄患者的中位数 GP 就诊次数为 10(6-17),而参考人群为 5(2-11)(P<0.001)。这些发现在年龄和性别上均一致。与参考组相比,无论 CCTA 结果如何,有和无狭窄的患者的 CCI 均较高。

结论

在因 CAD 而行 CCTA 检查的患者中,与参考人群相比,在检查前 5 年内,GP 就诊次数明显增加,而 CCTA 结果似乎并未明显影响 GP 就诊频率。

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