Peter Vedsted

General practice preventive health care in non-obstructive coronary artery disease determined by coronary computed tomography angiography

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General practice preventive health care in non-obstructive coronary artery disease determined by coronary computed tomography angiography. / Mols, Rikke Elmose; Nørgaard, Bjarne Linde; Vedsted, Peter; Farkas, Dora Körmendiné; Bøtker, Hans Erik; Jensen, Jesper Møller.

I: International Journal of Cardiology, Bind 278, 01.03.2019, s. 14-21.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{cc28d20445404900b2dd66a6012632f3,
title = "General practice preventive health care in non-obstructive coronary artery disease determined by coronary computed tomography angiography",
abstract = "Background: The aim of this study was to compare changes in health service utilization, preventive medical management, and cholesterol levels in patients without coronary artery disease (CAD) or with non-obstructive CAD as determined by coronary computed tomography angiography (CTA). Methods: Single-center five-year observational registry-based cohort study of consecutive patients with chest pain undergoing coronary CTA with subsequent 12 months follow-up in general practice. Results: We included 3032 patients with a normal test result (n = 2179) or a diagnosis of non-obstructive CAD (n = 853) by coronary CTA. Median age was 55 (interquartile range: 47–63) years and 44{\%} were males. After coronary CTA, the probability of a decrease in consultations with general practitioner was higher in patients with no CAD compared to patients with non-obstructive CAD (adjusted OR = 0.81 [95{\%} CI: 0.68–0.96], P = 0.016). Accordingly, patients with non-obstructive CAD more frequently received prescriptions on lipid-lowering medical therapy (adjusted OR = 4.50 [95{\%} CI: 3.31–6.12], P < 0.001) than patients with no CAD after coronary CTA. In patients with non-obstructive CAD, mean total-cholesterol reduction was 0.51 (P < 0.001) compared to 0.13 mmol/L (P < 0.001) in patients without non-obstructive CAD. The relative reduction in low-density lipoprotein was 14{\%} higher (P < 0.001) in patients with compared to patients without non-obstructive CAD after coronary CTA. Conclusions: Coronary CTA with subsequent follow-up in general practice has the potential to align health service utilization that prioritizes high-risk patients and facilitate optimized preventive management.",
keywords = "Atherosclerosis, Coronary computed tomography angiography, General practice, Health service utilization, Management, Preventive",
author = "Mols, {Rikke Elmose} and N{\o}rgaard, {Bjarne Linde} and Peter Vedsted and Farkas, {Dora K{\"o}rmendin{\'e}} and B{\o}tker, {Hans Erik} and Jensen, {Jesper M{\o}ller}",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.ijcard.2018.09.094",
language = "English",
volume = "278",
pages = "14--21",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd.",

}

RIS

TY - JOUR

T1 - General practice preventive health care in non-obstructive coronary artery disease determined by coronary computed tomography angiography

AU - Mols, Rikke Elmose

AU - Nørgaard, Bjarne Linde

AU - Vedsted, Peter

AU - Farkas, Dora Körmendiné

AU - Bøtker, Hans Erik

AU - Jensen, Jesper Møller

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: The aim of this study was to compare changes in health service utilization, preventive medical management, and cholesterol levels in patients without coronary artery disease (CAD) or with non-obstructive CAD as determined by coronary computed tomography angiography (CTA). Methods: Single-center five-year observational registry-based cohort study of consecutive patients with chest pain undergoing coronary CTA with subsequent 12 months follow-up in general practice. Results: We included 3032 patients with a normal test result (n = 2179) or a diagnosis of non-obstructive CAD (n = 853) by coronary CTA. Median age was 55 (interquartile range: 47–63) years and 44% were males. After coronary CTA, the probability of a decrease in consultations with general practitioner was higher in patients with no CAD compared to patients with non-obstructive CAD (adjusted OR = 0.81 [95% CI: 0.68–0.96], P = 0.016). Accordingly, patients with non-obstructive CAD more frequently received prescriptions on lipid-lowering medical therapy (adjusted OR = 4.50 [95% CI: 3.31–6.12], P < 0.001) than patients with no CAD after coronary CTA. In patients with non-obstructive CAD, mean total-cholesterol reduction was 0.51 (P < 0.001) compared to 0.13 mmol/L (P < 0.001) in patients without non-obstructive CAD. The relative reduction in low-density lipoprotein was 14% higher (P < 0.001) in patients with compared to patients without non-obstructive CAD after coronary CTA. Conclusions: Coronary CTA with subsequent follow-up in general practice has the potential to align health service utilization that prioritizes high-risk patients and facilitate optimized preventive management.

AB - Background: The aim of this study was to compare changes in health service utilization, preventive medical management, and cholesterol levels in patients without coronary artery disease (CAD) or with non-obstructive CAD as determined by coronary computed tomography angiography (CTA). Methods: Single-center five-year observational registry-based cohort study of consecutive patients with chest pain undergoing coronary CTA with subsequent 12 months follow-up in general practice. Results: We included 3032 patients with a normal test result (n = 2179) or a diagnosis of non-obstructive CAD (n = 853) by coronary CTA. Median age was 55 (interquartile range: 47–63) years and 44% were males. After coronary CTA, the probability of a decrease in consultations with general practitioner was higher in patients with no CAD compared to patients with non-obstructive CAD (adjusted OR = 0.81 [95% CI: 0.68–0.96], P = 0.016). Accordingly, patients with non-obstructive CAD more frequently received prescriptions on lipid-lowering medical therapy (adjusted OR = 4.50 [95% CI: 3.31–6.12], P < 0.001) than patients with no CAD after coronary CTA. In patients with non-obstructive CAD, mean total-cholesterol reduction was 0.51 (P < 0.001) compared to 0.13 mmol/L (P < 0.001) in patients without non-obstructive CAD. The relative reduction in low-density lipoprotein was 14% higher (P < 0.001) in patients with compared to patients without non-obstructive CAD after coronary CTA. Conclusions: Coronary CTA with subsequent follow-up in general practice has the potential to align health service utilization that prioritizes high-risk patients and facilitate optimized preventive management.

KW - Atherosclerosis

KW - Coronary computed tomography angiography

KW - General practice

KW - Health service utilization

KW - Management

KW - Preventive

U2 - 10.1016/j.ijcard.2018.09.094

DO - 10.1016/j.ijcard.2018.09.094

M3 - Journal article

C2 - 30309680

VL - 278

SP - 14

EP - 21

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -