Recommended Citation
Zidan A. Downstream Testing Following Coronary Computed Tomography Angiography: A Decade of Clinical Practice (2012–2022). Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Abstract
Background/Significance:
Coronary computed tomography angiography (CCTA) has become an essential non-invasive diagnostic tool for evaluating coronary artery disease (CAD). However, the clinical management and testing strategies after CCTA vary based on individual patient findings and institutional practices.
Purpose:
This study aims to analyze the downstream diagnostic and therapeutic procedures performed following CCTA at Aurora St. Luke Medical Center over a ten-year period.
Methods:
We performed a retrospective analysis of patients who underwent CCTA at Aurora St. Luke Medical Center between 2012 and 2022. The dataset included a total of 1,803 unique patients, with detailed records of all subsequent diagnostic and interventional procedures. We assessed the frequency and timing of downstream testing, with a focus on the most common procedures such as nuclear myocardial perfusion imaging (NM MPI), stress echocardiography (echo stress), coronary angiography, and percutaneous transluminal coronary angioplasty (PTCA).
Results:
Among the patients who had CCTA, 30% underwent downstream testing. The most common procedures following CCTA were NM myocardial perfusion imaging (29%) and coronary angiography (24%). Notably, 17% of patients required PTCA, either with or without stenting. Patients underwent additional diagnostic testing at various intervals following the CCTA, with a median time to the next procedure of 518 days (IQR: 87–1,029 days), although some procedures were performed immediately after the CCTA. The data revealed distinct testing pathways, where high-risk patients often received coronary angiograms and interventional procedures soon after CCTA, while others underwent non-invasive follow-up testing, such as NM MPI or echo stress, as part of long-term disease management.
Conclusion:
This ten-year analysis of downstream testing following CCTA at our institution demonstrates a diverse range of clinical follow-up strategies. The frequent use of nuclear myocardial perfusion imaging and coronary angiography highlights CCTA's role in guiding subsequent diagnostic and therapeutic interventions. The variability in timing suggests that CCTA results inform both urgent interventions and long-term surveillance in CAD management. These findings can inform clinical guidelines and help optimize post-CCTA care to improve patient outcomes.
Presentation Notes
Presented at Scientific Day; May 21, 2025; Park Ridge, IL.
Full Text of Presentation
wf_yes
Document Type
Poster
Open Access
Available to all.
Downstream Testing Following Coronary Computed Tomography Angiography: A Decade of Clinical Practice (2012–2022)
Background/Significance:
Coronary computed tomography angiography (CCTA) has become an essential non-invasive diagnostic tool for evaluating coronary artery disease (CAD). However, the clinical management and testing strategies after CCTA vary based on individual patient findings and institutional practices.
Purpose:
This study aims to analyze the downstream diagnostic and therapeutic procedures performed following CCTA at Aurora St. Luke Medical Center over a ten-year period.
Methods:
We performed a retrospective analysis of patients who underwent CCTA at Aurora St. Luke Medical Center between 2012 and 2022. The dataset included a total of 1,803 unique patients, with detailed records of all subsequent diagnostic and interventional procedures. We assessed the frequency and timing of downstream testing, with a focus on the most common procedures such as nuclear myocardial perfusion imaging (NM MPI), stress echocardiography (echo stress), coronary angiography, and percutaneous transluminal coronary angioplasty (PTCA).
Results:
Among the patients who had CCTA, 30% underwent downstream testing. The most common procedures following CCTA were NM myocardial perfusion imaging (29%) and coronary angiography (24%). Notably, 17% of patients required PTCA, either with or without stenting. Patients underwent additional diagnostic testing at various intervals following the CCTA, with a median time to the next procedure of 518 days (IQR: 87–1,029 days), although some procedures were performed immediately after the CCTA. The data revealed distinct testing pathways, where high-risk patients often received coronary angiograms and interventional procedures soon after CCTA, while others underwent non-invasive follow-up testing, such as NM MPI or echo stress, as part of long-term disease management.
Conclusion:
This ten-year analysis of downstream testing following CCTA at our institution demonstrates a diverse range of clinical follow-up strategies. The frequent use of nuclear myocardial perfusion imaging and coronary angiography highlights CCTA's role in guiding subsequent diagnostic and therapeutic interventions. The variability in timing suggests that CCTA results inform both urgent interventions and long-term surveillance in CAD management. These findings can inform clinical guidelines and help optimize post-CCTA care to improve patient outcomes.
Affiliations
Aurora St. Luke’s Medical Center