Purpose: Authors aim to investigate if the scepticism on CTCA results and the request for ICA to confirm CTCA findings are influenced by the Consultant Cardiologist subspecialty (Interventional vs Non-interventional).
Methods: Single centre prospective audit study, including 400 consecutive patients with stable chest pain who were referred to CTCA. Demographic, CTCA and downstream testing data were collected. Statistical analysis was performed using STATA v14. p<0.05 was considered statistically significant.
Results: 400 patients were included, with mean age of 61 ± 12.2 years, 202 (52.6%) men, with a mean BMI of 28.9 ± 6.4. 387 (96.8%) CTCAs were diagnostic. Coronary artery disease (CAD) was diagnosed in 229 (57.3%) patients, and the mean CAD-RADS was 1.38 ± 1.6. 67 (16.8%) patients had ICA after the CTCA. Patients whose CTCA was requested by an Interventional Cardiologist, rather than a Non-interventional Cardiologist, had a higher probability of being submitted to ICA after the CTCA (23.4% vs. 13.3%, p=0.049). When adjusting for CAD-RADS, although the fact that the CTCA was requested by an Interventional Cardiologist was associated with a two-fold increase in the chance of having ICA, that difference became non-statistically significant (odds ratio 2.1, 95% CI 0.8-5.7, p=0.153).
Conclusion: In our study, a trend (not statistically significant) was found with respect to increased likelihood of ICA requested as a downstream test by Interventional Cardiologists.