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- W159888970 abstract "textabstractFor several decades invasive coronary angiography (CA) has been the referencestandard in the assessment of coronary artery disease (CAD) severity. Patients withhigh pre-test likelihood of CAD, receive a Class 1 indication for CA. Several factors,however, motivate the need for a reliable non-invasive imaging modality, especiallyin patients with a high pre-test likelihood. Not only to rule out, but also to reliablydiagnose coronary stenosis with functional consequences (significant CAD) andguide therapeutic decision making.Performance of CA in all patients with high pre-test likelihood of CAD hasundeniable drawbacks. First of all, the prevalence of angiographically significant CADin patients with high pre-test likelihood may be as low as 44-46%. In real life,the prevalence of significant CAD in patients referred for CA is even lower at only36.7%, according to the national cardiovascular data registry of the United States .Secondly, angiographic severity of CAD does not reliably predict its main functionalconsequence: myocardial ischemia 6-8. Because evidence of myocardial ischemia isneeded before deciding whether revascularization is necessary, additional (non-) invasive tests are needed . Finally, CA comes with high costs as a result of theneed for admission to a hospital or day-care facility and a low risk (0.1%) of seriousadverse events .With the advent of computed tomography coronary angiography (CCTA) andthe known reliability of single photon emission computed tomography myocardialperfusion imaging (SPECT-MPI) a combination of non-invasive imaging modalitiesbecame available that potentially could reliably diagnose significant CAD. The highdiagnostic accuracy of this combination has previously been shown in highly selectedpatient populations. Nevertheless, data demonstrating the applicability of hybridSPECT and CCTA in diagnosing significant CAD in stable patients with an intermediateto high pre-test likelihood of CAD are still lacking. Furthermore, the contribution ofthese tests to therapeutic decision making in these patients is unknown. Providingevidence on both of these issues is the main objective of this thesis." @default.
- W159888970 created "2016-06-24" @default.
- W159888970 creator A5071555541 @default.
- W159888970 date "2013-10-04" @default.
- W159888970 modified "2023-09-27" @default.
- W159888970 title "Non-invasive imaging of coronary artery disease and its functional consequences- The Hybrid SPECT and CCTA approach" @default.
- W159888970 hasPublicationYear "2013" @default.
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