Statin, Aspirin Therapy May Be Adjusted With Coronary CT Angiography Findings

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Knowledge of CCTA results may improve alignment of aspirin and statin prescribing.
Knowledge of CCTA results may improve alignment of aspirin and statin prescribing.

(HealthDay News) — Knowledge of coronary computed tomography angiography (CCTA) results is associated with improved alignment of aspirin and statin prescribing with the presence and severity of coronary artery disease (CAD), according to a study published in The American Journal of Cardiology.

Amit Pursnani, MD, from Massachusetts General Hospital in Boston, and colleagues examined whether knowledge of CCTA-based CAD correlated with modification of statin and aspirin prescription. Data were included from the CCTA arm of the Rule Out Myocardial Infarction using Computed Angiographic Tomography II multicenter, randomized control trial (R-II; 370 patients), and the comparison cohort from the Rule Out Myocardial Infarction using Computed Angiographic Tomography I cohort (R-I; 277 patients).

The rate of acute coronary syndrome (ACS) was similar for R-I and R-II (6.9% and 6.2%, respectively; P=.75). The researchers found that statin initiation was greater after disclosure of CCTA results among patients with CCTA-detected obstructive CAD without ACS (0% in R-I vs 20% in R-II; P=.009). 

Aspirin prescription was lower with disclosure of CCTA results among patients without CCTA-detected CAD (16% in R-I vs 4.8% in R-II; P=.001). Within R-II, only 68% and 65% of patients with obstructive CAD were discharged on statin and aspirin, respectively.

"Our findings suggest opportunity for practice improvement when CCTA is performed in the emergency department," the researchers wrote.

Reference

  1. Pursani A, Celeng C, Schett CL, et al. Use of Coronary Computed Tomographic Angiography Findings to Modify Statin and Aspirin Prescription in Patients With Acute Chest Pain. Am J Cardiol. 2016;117(3):319-324.
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