P06 A multidisciplinary team approach to chronic coronary syndromes, a single centre in South London

Résumé fourni par la source

Introduction Ascertain the percentage of patients in whom judicious use of Computed Tomography Coronary Angiogram (CTCA) and Fractional Flow Reserve (FFRct) prevented unnecessary invasive angiograms. Methods We analysed the reports of all CTCAs performed in Kingston Hospital between January 2021 and 2023. We selected the patients discussed in CAD MDT and reviewed their records. This allowed us to calculate the percentage of cases where invasive angiography was averted. Lastly using a chi-square test we established the difference between the cases requiring inpatient angiography and those that did not. Results In this 2year period, of the 1686 CTCA s performed 164 revealed lesions that warranted further investigation and were sent to FFRct and later reviewed in the CAD MDT meeting. 60% (98) of patients were discharged to outpatient follow and conservative management. 65 patients (64%) had positive FFRct. 62 were referred for angiogram. For the remaining 3 patients, the lesion did not correspond to a flow deficit and therefore angiogram was not appropriate. We observed a reduction of 62% in the rate of inpatient angiograms, with a chi-square test result of 128.66, p-value of <0.001. Conclusion Our findings show a significant reduction in the number of angiograms performed. This reduction is a potential consequence of the MDT approach and appropriate use of CTCA and FFRCT. This not only spares patients from undergoing invasive procedures with its inherent risks and complications. but also reduces the burden on trusts by directly decreasing the number of admissions, treatment cost and referrals to tertiary centres.

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