Temporal trend and regional disparity in the investigations for stable chest pain in Europe: An insight from the PIONEER IV trial.

Tsung-Ying Tsai, Patrick W Serruys, Joanna Wykrzykowska, Faisal Sharif, Liesbeth Rosseel, Edouard Benit, Mohammad Alkhalil, Kenneth De Wilder, Nick Curzen, Mick Renkens, Pruthvi C Revaiah, Andreas Baumbach, Pieter C Smits, Patrick Nash, Scot Garg, Marc Dewey, Thomas F Lüscher, Yoshinobu Onuma
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Abstract

Coronary CT angiography (CCTA) and fractional flow reserve with CCTA (FFRCT) have been endorsed by the ACC/AHA Chest Pain guidelines to streamline the diagnosis of coronary artery disease (CAD), but there is still a significant lack of adherence. In our study of 673 stable chest patients without known CAD from 5 European countries, we found that CCTA is the most common noninvasive diagnostic test, but nearly 40 ​% of them still underwent upfront CAD. Additionally, there was no temporal improvement trend, and the integration of FFRCT is low. We highlighted the urgent need to improve diagnostic processes and update reimbursement policies.

欧洲稳定型胸痛调查的时间趋势和地区差异:PIONEER IV 试验的启示。
冠状动脉 CT 血管造影 (CCTA) 和冠状动脉 CTA 分形血流储备 (FFRCT) 已被 ACC/AHA 胸痛指南批准用于简化冠状动脉疾病(CAD)的诊断,但仍存在严重的缺乏性。我们对来自 5 个欧洲国家的 673 名无已知 CAD 的稳定胸痛患者进行了研究,发现 CCTA 是最常见的无创诊断检查,但其中仍有近 40% 的患者接受了前期 CAD 检查。此外,CCTA 在时间上没有改善的趋势,而 FFRCT 的整合率也很低。我们强调了改进诊断流程和更新报销政策的迫切性。
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