Computed Tomography Cardiac Angiography Before Invasive Coronary Angiography in Patients With Previous Bypass Surgery: The BYPASS-CTCA Trial
Authors' conclusion
For patients with previous coronary artery bypass grafting, CTCA before ICA leads to reductions in procedure time and contrast-induced nephropathy, with improved patient satisfaction.
Study context
- Population
- Patients with previous CABG referred for invasive coronary angiography (ICA)
- Participants
- 688 patients
- Comparison
- Computed tomography cardiac angiography (CTCA) before ICA vs ICA alone
- Primary endpoint
- Co-primary: ICA procedural duration, patient satisfaction after ICA (validated questionnaire), incidence of contrast-induced nephropathy
Methodological detailssingle-centre, open-label
- Single-centre
- Open-label
Primary result
As reported in the abstract
CTCA+ICA
- Procedure duration (mean±SD)
- 18.6±9.5 minutes
- Contrast-induced nephropathy
- 3.4%
ICA alone
- Procedure duration (mean±SD)
- 39.5±16.9 minutes
- Contrast-induced nephropathy
- 27.9%
Procedure duration (mean±SD)
CTCA+ICA18.6±9.5 minutes
ICA alone39.5±16.9 minutes
Contrast-induced nephropathy
CTCA+ICA3.4%
ICA alone27.9%
CTCA+ICA vs ICA aloneDifference (98.33% CI)P value
Mean ICA satisfaction score (1=very good to 5=very poor)
−1.1(−1.2 to −0.9)
P < 0.001CTCA+ICA vs ICA aloneOdds ratio (98.33% CI)P value
Contrast-induced nephropathy
0.09(0.04–0.2)
P < 0.001Secondary outcomes
| Outcome | CTCA+ICA | ICA alone | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| 1-year MACE | 16.0% | 29.4% | 0.4 (0.3–0.6) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Safety
| Outcome | CTCA+ICA | ICA alone | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Procedural complications | 2.3% | 10.8% | 0.2 (0.1–0.4) | P < 0.001 | |
| 0.10.31310Odds ratio (log scale) |
Original publication
Computed Tomography Cardiac Angiography Before Invasive Coronary Angiography in Patients With Previous Bypass Surgery: The BYPASS-CTCA Trial. Circulation. Published 29 September 2023. doi:10.
Summarised from the published abstract; every number is checked against it