{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,9]],"date-time":"2025-11-09T03:45:57Z","timestamp":1762659957656,"version":"3.41.2"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Although guidelines recommend the use of coronary computed tomographic angiography (CTA) in patients with stable pain syndromes, the clinical benefits of the use of coronary CTA in a broad spectrum of patients is unknown. We evaluated the contemporary practice pattern and diagnostic yield of coronary CTA and their impact on the subsequent diagnostic\u2010therapeutic cascade and clinical outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We identified 39\u00a0906 patients without known coronary artery disease (CAD) who underwent coronary CTA between January 2007 and December 2013. The patients' demographic characteristics, risk factors, symptoms, results of coronary CTA, the appropriateness of downstream diagnostic and therapeutic interventions, and long\u2010term outcomes (death or myocardial infarction) were evaluated. The number of coronary CTAs had increased over time, especially in asymptomatic patients. Coronary CTA revealed that 6108 patients (15.3%) had obstructive CAD (23.7% of symptomatic and 9.3% of asymptomatic patients). Subsequent cardiac catheterization was performed in 19.2% of symptomatic patients (appropriate, 80.6%) and in 3.9% of asymptomatic patients (appropriate, 7.9%). The 5\u2010year rate of death or myocardial infarction was significantly higher in patients with obstructive CAD on CTA than those without (7.2% versus 3.0%;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; adjusted hazard ratio [95% CI], 1.34 [1.17\u20131.54]). However, obstructive CAD on CTA had limited added value over conventional risk factors for predicting death or myocardial infarction.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Although the use of coronary CTA had substantially increased, CTA had a low diagnostic yield for obstructive CAD, especially in asymptomatic patients. The use of CTA in asymptomatic patients seemed to have led to inappropriate subsequent diagnostic or therapeutic interventions without clinical benefit.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.016620","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T09:30:32Z","timestamp":1599557432000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Practice Pattern, Diagnostic Yield, and Long\u2010Term Prognostic Impact of Coronary Computed Tomographic Angiography"],"prefix":"10.1161","volume":"9","author":[{"given":"Min Soo","family":"Cho","sequence":"first","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae\u2010Hyung","family":"Roh","sequence":"additional","affiliation":[{"name":"Department of Cardiology Chungnam National University Hospital Daejeon Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanbit","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7587-5037","authenticated-orcid":false,"given":"Sang\u2010Cheol","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Do\u2010Yoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pil Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jung\u2010Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyun Jung","family":"Koo","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong Hyun","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joon\u2010Won","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Radiology and Research Institute of Radiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9187-5405","authenticated-orcid":false,"given":"Seung\u2010Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manesh R.","family":"Patel","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6643-0239","authenticated-orcid":false,"given":"Duk\u2010Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.013"},{"key":"e_1_3_2_3_2","first-page":"2949","article-title":"2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology","author":"Montalescot G","year":"2013","unstructured":"Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, Bugiardini R, Crea F, Cuisset T, Di Mario C, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. 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