Noninvasive CT scan before coronary angiography improves satisfaction, outcomes in patients with prior CABG: BYPASS-CTCA

USA: A noninvasive CT scan before invasive coronary angiography improved patient satisfaction and reduced procedure duration and contrast-induced nephropathy, according to findings from the BYPASS-CTCA trial. The results were presented at the Transcatheter Cardiovascular Therapeutics meeting (TCT 2022) in Boston on September 19. 

The trial was conducted to evaluate if a noninvasive computed tomography (CT) scan before invasive coronary angiography is beneficial for procedural outcomes in patients with prior coronary artery bypass grafting (CABG).

The randomized, parallel trial enrolled 688 patients with prior CABG requiring invasive coronary angiography. They were randomized to a noninvasive CT scan versus a control. They were followed for 12 months.

The main findings of the study include:

· With CCTA before ICA, a 66% relative reduction in procedural duration (17.4 vs. 39.5 minutes) was seen as well as a 40% relative improvement in patient satisfaction (1.49 vs. 2.54) and 92% relative risk reduction in the risk of contrast-induced nephropathy (3.2% vs. 27.9%) was observed.

· Also, there was an 80% reduction in procedural complications, such as stroke, heart attack, or bleeding (10.8% vs. 2.4%), and a 7.7% boost in quality of life at 12 months.

The findings were presented by Daniel Jones, who said, "the problem with invasive coronary angiography in patients with previous CABG is that it is more complex and challenging – no operation is the same." He added that the findings from the BYPASS-CTCA trial provide helpful information that hopefully will l hopefully result in shorter and potentially safer procedures.

"A pre-procedure noninvasive CT scan among patients with prior CABG requiring invasive coronary angiography seemed beneficial," the researchers wrote in their presentation. "A noninvasive CT scan was linked with a reduction in contrast-induced nephropathy, procedure duration, and improvement in patient satisfaction. A noninvasive CT scan was tied to a reduction in procedural complications." 

Reference:

Can a Noninvasive CT Scan Prior to Invasive Coronary Angiography Improve Procedural Outcomes in Patients With Prior Coronary Artery Bypass Grafting - BYPASS-CTCA