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17 Coronary angiography in a district general hospital
  1. Matthew GL Williams1,
  2. Danial Fox2,
  3. David H MacIver1,
  4. Mark Dayer1,
  5. Katharine Augustine2,
  6. Paul Burn2,
  7. OE Gosling1
  1. 1Department of Cardiology, Taunton and Somerset Hospital, Musgrove Park, Taunton, UK
  2. 2Department of Radiology, Taunton and Somerset Hospital, Musgrove Park, Taunton, UK

Abstract

Introduction CTCA is now an established diagnostic tool in the evaluation of chest pain, and with the recently up-dated NICE CG95 guidelines its use is likely to increase nationally.1 We aimed to assess the demographics of our local patient cohort, protocol use, radiation dose and the accuracy and outcomes from our CT service.

Methods Demographic and outcome data was collected for a 17 month period from Jul 2015–Nov 2016. The CTCA result was compared with the invasive angiogram in patients who had both investigations.

Results 689 scans were performed with 95% for rule out of coronary artery disease. 8% of the scan protocols used were calcium scores only, 25% were prospectively ECG triggered spiral acquisition (FLASH), 60% prospective, 4% retrospective and 3% required more than 2 contrast scans. Mean BMI was?29±11 Kgm−2, median DLP 137 mGy*cm (IQR 87–230 mGy*cm), mean acquisition heart rate 61±21 bpm and median IV metoprolol dosage used was 8mg (IQR 0–20 mg). 98% of scans were diagnostic. 11% were referred on for angiography, 88% were recommended medical therapy and 1% were referred for MRI. There was 80% agreement with coronary angiography with 65% proceeding to intervention. 0% of patients who had a negative CTCA required subsequent intervention (before 15/11/16).

Conclusion Our real-world data demonstrates that CTCA in a district general hospital is an accurate and effective way to rationalise investigations, particularly in the management of coronary artery disease.

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