title: Changes in Medical Management after Coronary CT Angiography.
abstract: BACKGROUND
  Coronary computed tomography angiography (CCTA) allows for non-invasive coronary artery disease (CAD) phenotyping. There are still some uncertainties regarding the impact this knowledge has on the clinical care of patients.
  
  
  OBJECTIVE
  To determine whether CAD phenotyping by CCTA influences clinical decision making by the prescription of cardiovascular drugs and their impact on non-LDL cholesterol (NLDLC) levels.
  
  
  METHODS
  We analysed consecutive patients from 2008 to 2011 submitted to CCTA without previous diagnosis of CAD that had two serial measures of NLDLC, one up to 3 months before CCTA and the second from 3 to 6 months after.
  
  
  RESULTS
  A total of 97 patients were included, of which 69% were men, mean age 64 ± 12 years. CCTA revealed that 18 (18%) patients had no CAD, 38 (39%) had non-obstructive (< 50%) lesions and 41 (42%) had at least one obstructive ≥ 50% lesion. NLDLC was similar at baseline between the grups (138 ± 52 mg/dL vs. 135 ± 42 mg/dL vs. 131 ± 44 mg/dL, respectively, p = 0.32). We found significative reduction in NLDLC among patients with obstrctive lesions (-18%, p = 0.001). We also found a positive relationship between clinical treatment intensification with aspirin and cholesterol reducing drugs and the severity of CAD.
  
  
  CONCLUSIONS
  Our data suggest that CCTA results were used for cardiovascular clinical treatment titration, with especial intensification seen in patients with obstructive ≥50% CAD.
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Vânia Mairi
authors.initials: VM
authors.lastname: Naue
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Camargo
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Letícia Roberto
authors.initials: LR
authors.lastname: Sabioni
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Ronaldo de Souza Leão
authors.initials: Rde S
authors.lastname: Lima
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Maria Eduarda
authors.initials: ME
authors.lastname: Derenne
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Andréa Rocha de
authors.initials: AR
authors.lastname: Lorenzo
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Monica Di Calafiori
authors.initials: MD
authors.lastname: Freire
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Clério Francisco
authors.initials: CF
authors.lastname: Azevedo Filho
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Elmiro Santos
authors.initials: ES
authors.lastname: Resende
authors.affiliation: CDPI - Clínica de Diagnóstico por Imagem, Brazil.
authors.forename: Ilan
authors.initials: I
authors.lastname: Gottlieb
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002784:Cholesterol / Q000097:blood*; D000066491:Clinical Decision-Making; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D019468:Disease Management; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D000924:Anticholesteremic Agents; D010975:Platelet Aggregation Inhibitors; D002784:Cholesterol; D001241:Aspirin