Acceptance of Combined Coronary CT Angiography and Myocardial CT Perfusion versus Conventional Coronary Angiography in Patients with Coronary Stents--Intraindividual Comparison.
OBJECTIVE
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).


BACKGROUND
While combined CTA and CTP may improve diagnostic accuracy compared with CTA alone, patient acceptance of CTA/CTP remains to be defined.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.


BACKGROUND
ClinicalTrials.gov NCT00967876.
Department of Radiology, Charité, Medical School, Berlin, Germany.
Matthias
M
Rief
Department of Radiology, Charité, Medical School, Berlin, Germany.
Sarah
S
Feger
Institute for Clinical Epidemiology and Applied Biostatistics, Eberhard Karls University Tübingen, Germany.
Peter
P
Martus
Department of Cardiology, Charité, Medical School, Berlin, Germany.
Michael
M
Laule
Department of Radiology, Charité, Medical School, Berlin, Germany.
Marc
M
Dewey
Department of Medicine, Medical School Hannover, Hannover, Germany.
Eva
E
Schönenberger
D000368:Aged; D001807:Blood Vessel Prosthesis; D017023:Coronary Angiography / Q000523:psychology*; D003327:Coronary Disease / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000523:psychology*; D010146:Pain / Q000209:etiology; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D057240:Patient Preference / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015607:Stents; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed / Q000523:psychology