201 Computed tomography cardiac angiography (CTCA) changes the management of stable chest pain patients – a single centre experience

Introduction Computed Tomography Cardiac Angiography (CTCA) is now the first-line recommended investigation as per the NICE in new-onset stable chest pain patients. European and International guidance however still recommends risk stratification and functional testing in high and intermediate risk individuals. Methods We performed a retrospective review of stable chest pain patients who had a CTCA on an outpatient basis between January – March 2023. Data was collected using a pre-designed proforma, demographic data, risk factor profile including QRISK, indication for scan, CTCA result and outcome following scan were collected. Statistical analysis was performed using Microsoft Excel software; unpaired t-testing was used to evaluate statistical significance. Results 99 patients were included in this retrospective review 49/99 (49%) patients were male, median age was 57 years. Most common co-morbidities included hypertension (28%), hyperlipidaemia (34%). Median QRISK3 score was 7.8% (table 1) The most common reason for referral for CTCA was atypical chest pain in 75/99 (76%) patients. Mean Calcium score was 41. All patients with severe coronary stenosis (>70%) identified on CTCA proceeded to have LHC+/-PCI. CTCA changed patient management in most cases, in 34/99 cases it led to a change in medication regime namely primary prevention initiation. 10 patients had functional assessment following the CTCA result. 13 patients underwent invasive coronary angiography (ICA) following CTCA. 5/13 had percutaneous coronary intervention and 1/13 patients was referred for CABG. Higher QRISK score was associated with increased number of vessel stenosis (pConclusions Outpatient CTCA imaging in the stable chest pain cohort can lead to significant changes in patient management. In 34/99 cases primary prevention was optimised and in 44 patients the CTCA demonstrated no coronary disease/plaque leading to discharge from the Cardiology services hence demonstrating its utility as a rule-out test for epicardial obstructive coronary artery disease in a low-risk population. Conflict of Interest None