Impact of atherosclerosis imaging-quantitative computed tomography on diagnostic certainty, downstream testing, coronary revascularization, and medical therapy: the CERTAIN study
Authors' conclusion
The use of AI-QCT improves diagnostic certainty and may result in reduced downstream need for non-invasive testing and increased rates of preventive medical therapy.
Study context
- Population
- Consecutive adults referred for coronary CT angiography (CCTA) (mean age 63.8 ± 12.2 years; 57.7% male)cross-over
- Participants
- 750 adults
- Exposure
- Atherosclerosis imaging-quantitative computed tomography (AI-QCT) vs conventional visual CCTA interpretation
- Outcome
- Change in diagnosis or management (clinical utility)
Methodological detailsmulticentre, 5 expert CCTA sites, consecutive patients, physicians blinded to AI-QCT for initial assessment
- Multicentre
- 5 expert CCTA sites
- Consecutive patients
- Physicians blinded to AI-QCT for initial assessment
Main finding
As reported in the abstract
Change in diagnosis or management with AI-QCT vs conventional evaluation
Change in diagnosis or management
428; 57.1%
P < 0.001
Change in Coronary Artery Disease-Reporting and Data System (CAD-RADS)
295; 39.3%
P < 0.001
Change in plaque burden
197; 26.3%
P < 0.001
Observational data: associations, not effects.
Further findings
Need for downstream non-invasive and invasive testing (AI-QCT incl. ischaemia assessment)
- Reduction vs conventional site CCTA evaluation
- 37.1% (P < 0.001)
Preventive medical therapy
- Additional statin initiation/increase
- 28.1% (P < 0.001)
- Additional aspirin initiation
- 23.0% (P < 0.001)
Original publication
Impact of atherosclerosis imaging-quantitative computed tomography on diagnostic certainty, downstream testing, coronary revascularization, and medical therapy: the CERTAIN study. Eur Heart J Cardiovasc Imaging. Published 25 January 2024. doi:10.
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