A non-invasive CT scan prior to invasive coronary angiography (ICA) reduced procedural duration and complications and improved satisfaction in patients who had previously undergone CABG for coronary artery disease, according to findings from the BYPASS-CTCA trial presented Sept. 19 during TCT 2022 in Boston.

The trial out of the UK, randomized 688 patients with previous CABG to undergo computerized tomography coronary angiography (CTCA) prior to ICA or ICA alone. The primary endpoints were procedural duration, patient satisfaction scores post ICA, and the amount of contrast-induce nephropathy. Secondary endpoints included complications associated with ICA, clinical events up to 12 months and patient-related quality of life at 12 months.

Results showed a 66% relative reduction in procedural duration (17.4 vs. 39.5 minutes) with CCTA prior to ICA, as well as 92% relative risk reduction in the incidence of contrast-induced nephropathy (3.2% vs. 27.9%) and a 40% relative improvement in patient satisfaction (1.49 vs. 2.54). There was also an 80% reduction in procedural complications, such as heart attack, bleeding or stroke, (10.8% vs. 2.4%) and a 7.7% improvement in quality of life at 12 months.

"The problem with [ICA] in patients with previous CABG is that it is more complex and challenging – no operation is the same," said Daniel Jones, MD, who presented the findings. He said the BYPASS-CTCA findings provide useful information that will hopefully lead to shorter and potentially safer procedures.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Atherosclerotic Disease (CAD/PAD), Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: Transcatheter Cardiovascular Therapeutics, TCT22, Coronary Angiography, Patient Satisfaction, Coronary Artery Bypass, Tomography, Coronary Artery Disease

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