| Title: |
Drugless and radiographer led: the start of a new era for CT coronary angiography |
| Authors: |
Morgan-Hughes, G.; McNally, R.; Gibbs, C. G.; Iacovides, S.; Kirat-Rai, P.; Thiriphoo, N.; Powell, A.; Stuckey, C.; Thorpe, R.; Mayo, L.; Roobottom, C. |
| Publisher Information: |
BMJ |
| Publication Year: |
2023 |
| Collection: |
RD&E Research Repository (Royal Devon and Exeter NHS Foundation Trust) |
| Subject Terms: |
Humans; Female; Middle Aged; Male; Coronary Angiography; Coronary Artery Disease/diagnostic imaging; Computed Tomography Angiography/adverse effects; Tomography; X-Ray Computed; Chest Pain; Computed Tomography Angiography; Diagnostic Imaging; Quality of Health Care |
| Description: |
OBJECTIVE: Since inception CT coronary angiography (CTCA) has required facilitating beta blockers (BB). However, CT technology has improved rapidly as has radiographer and reporter expertise. Using these factors, we instituted a radiographer led cardiac CT service (RLCCTS), without routine BB, which we studied for quality control (QC). METHODS: RLCCTS started October 2021 using a wide detector array CT system, with 20 min slots. QC study was registered with the clinical audit team, University Hospitals Plymouth, CA_2020-21-118. Uniform reporting was agreed including indication, BB administration, demographics, dose length product (DLP) and the coronary artery disease-reporting and data system (CAD-RADS) score. Uncertain CAD-RADS meant a non-diagnostic scan (NDS). Six months of data were collected; stable chest pain (SCP) patients, who have national CTCA QC comparators, were analysed using descriptive statistics. RESULTS: Of 1475 patients, 447 were not SCP patients-known CAD (157); valves (286); removed (4, data incomplete) leaving 1028 SCP patients CTCA for analysis. Demographics-mean age 63 years, body mass index 29, 50.4% women. BB therapy-four patients (two recalls). Overall, 36/1024 or 3.5% were NDS; median DLP 173mGy×cm; mean heart rate (HR) 70 bpm, 99/1024 or 9.7% HR >90 bpm (45% not sinus rhythm). CONCLUSIONS: Quality for RLCCTS was judged by NDS rate and DLP. National QC comparators suggest 4% NDS rate; median DLP for SCPP CTCA 209 mGy×cm. RLCCTS compares favourably. With modern cardiac CT, experienced radiographers and reporters, 'drugless' RLCCTS can deliver 20 min slot CTCA with satisfactory QC indicators. ; Published version, accepted version, submitted version ; The article is available via Open Access. Click on the 'Additional link' above to access the full-text. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
https://openheart.bmj.com/lookup/pmidlookup?view=long&pmid=37349131; Open heart; PMC10314642; https://hdl.handle.net/11287/622996 |
| DOI: |
10.1136/openhrt-2023-002263 |
| Availability: |
https://hdl.handle.net/11287/622996; https://doi.org/10.1136/openhrt-2023-002263 |
| Rights: |
© Author(s) (or their employer(s)) 2023. |
| Accession Number: |
edsbas.4C28009A |
| Database: |
BASE |