Early coronary computed tomography angiography (CCTA) significantly reduced the need for subsequent outpatient testing compared to standard of care in women with suspected acute coronary syndrome (3.3% vs 12.4%), who also demonstrated a lower incidence of obstructive CAD than men.
RCT (n=500)
Open-label
Randomized
Yes
Does a diagnostic strategy including early CCTA compared to standard of care result in sex-associated differences in healthcare utilization for patients with suspected ACS?
In patients with suspected ACS, early CCTA reveals a lower burden of obstructive CAD in women compared to men, leading to less downstream outpatient testing and hospital admissions.
Absolute Event Rate: 3.3% vs 12.4%
p-value: p=0.008
Abstract Aim The optimal diagnostic test in the work-up of suspected acute coronary syndrome (ACS) may differ between men and women. The aim of this study was to compare sex-associated differences between using a diagnostic strategy including early coronary computed tomography angiography (CCTA) and standard of care (SOC). Methods In total, 500 patients who presented with symptoms suggestive of ACS at the emergency department were randomised between a diagnostic strategy supplemented with early CCTA and SOC. Results Women were generally older than men (mean ± standard deviation 56 ± 10 vs 53 ± 10 years, p 50% luminal narrowing) was less frequently seen in women (14% vs 26%, p = 0.02), and ACS was diagnosed less often in women (5% vs 10%, p = 0.03). Women underwent less outpatient testing when early CCTA was used in the emergency department evaluation of suspected ACS ( p = 0.008). Conclusion Women had a lower incidence of obstructive CAD on CCTA and were less often admitted to hospital than men. They were subjected to less outpatient testing when early CCTA was used in the emergency department evaluation of suspected ACS.
Arslan et al. (Fri,) conducted a rct in Suspected acute coronary syndrome (n=500). Early coronary computed tomography angiography (CCTA) vs. Standard of care (SOC) was evaluated on Outpatient testing within 30 days in women (p=0.008). Early coronary computed tomography angiography (CCTA) significantly reduced the need for subsequent outpatient testing compared to standard of care in women with suspected acute coronary syndrome (3.3% vs 12.4%), who also demonstrated a lower incidence of obstructive CAD than men.