Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population

Louise Nissen; Jacob Hartmann Søby; Annette de Thurah; Eva Prescott; Anders Prior; Simon Winther; Morten Bøttcher

doi:10.1093/ehjqcco/qcad074

Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population

Louise Nissen, Jacob Hartmann Søby, Annette de Thurah, Eva Prescott, Anders Prior, Simon Winther, Morten Bøttcher

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background Most patients undergoing coronary computed tomography angiography (CCTA) to diagnose coronary artery disease (CAD) are referred from general practitioners (GPs).The burden of contacts to GP in relation to investigation of suspected CAD is unknown. Methods and All patients undergoing CCTA in Western Denmark from 2014 to 2022 were included.CCTA stenosis was defined results as diameter stenosis of ≥50%.Patients with and without stenosis were matched, in each group, 1:5 to a reference population based on birth year, gender, and municipality using data from national registries.All GP visits were registered up to 5 years preceding and 1 year after the CTA and stratified by gender and age.Charlson comorbidity index (CCI) was calculated in all groups.Of the 62 512 patients included, 12 886 had a stenosis, while 49 626 did not.Patients in both groups had a substantially higher GP visit frequency compared with reference populations.In the year of coronary CTA, the median GP contacts in patients with stenosis were 11 (6-17) vs.6 (2-11) in the reference population (P < 0.001), and in patients without stenosis, the median GP contacts were 10 (6-17) vs.5 (2-11) (P < 0.001).These findings were consistent across age and gender.CCI was higher among both patients with and without stenosis compared with reference groups. Conclusion In patients undergoing CCTA to diagnose CAD, a substantially increased frequency of contacts to GP was observed in the 5-year period prior to examination compared with the reference populations, regardless of the CCTA findings.Obtaining the CCTA result did not seem to substantially affect the GP visit frequency.Graphical Patients undergoing coronary CTA due to symptoms suggestive of chronic coronary syndrome have an increased use Abstract visits to general practitioners in a 5 year period prior to examination, compared to a reference population.

Original language	English
Journal	European heart journal - Quality of care & clinical outcomes
Volume	10
Issue	7
Pages (from-to)	623-631
Number of pages	9
ISSN	2058-1742
DOIs	https://doi.org/10.1093/ehjqcco/qcad074
Publication status	Published - 1 Nov 2024

Keywords

Chronic coronary syndrome
Coronary computed tomography angiography
Coronary stenosis
General practice utilization
Primary health

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10.1093/ehjqcco/qcad074

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Nissen, L., Søby, J. H., de Thurah, A., Prescott, E., Prior, A., Winther, S., & Bøttcher, M. (2024). Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population. European heart journal - Quality of care & clinical outcomes, 10(7), 623-631. https://doi.org/10.1093/ehjqcco/qcad074

@article{696c0fae1e4640909bb0c518a9443da0,

title = "Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population",

abstract = "Background Most patients undergoing coronary computed tomography angiography (CCTA) to diagnose coronary artery disease (CAD) are referred from general practitioners (GPs).The burden of contacts to GP in relation to investigation of suspected CAD is unknown. Methods and All patients undergoing CCTA in Western Denmark from 2014 to 2022 were included.CCTA stenosis was defined results as diameter stenosis of ≥50%.Patients with and without stenosis were matched, in each group, 1:5 to a reference population based on birth year, gender, and municipality using data from national registries.All GP visits were registered up to 5 years preceding and 1 year after the CTA and stratified by gender and age.Charlson comorbidity index (CCI) was calculated in all groups.Of the 62 512 patients included, 12 886 had a stenosis, while 49 626 did not.Patients in both groups had a substantially higher GP visit frequency compared with reference populations.In the year of coronary CTA, the median GP contacts in patients with stenosis were 11 (6-17) vs.6 (2-11) in the reference population (P < 0.001), and in patients without stenosis, the median GP contacts were 10 (6-17) vs.5 (2-11) (P < 0.001).These findings were consistent across age and gender.CCI was higher among both patients with and without stenosis compared with reference groups. Conclusion In patients undergoing CCTA to diagnose CAD, a substantially increased frequency of contacts to GP was observed in the 5-year period prior to examination compared with the reference populations, regardless of the CCTA findings.Obtaining the CCTA result did not seem to substantially affect the GP visit frequency.Graphical Patients undergoing coronary CTA due to symptoms suggestive of chronic coronary syndrome have an increased use Abstract visits to general practitioners in a 5 year period prior to examination, compared to a reference population.",

keywords = "Chronic coronary syndrome, Coronary computed tomography angiography, Coronary stenosis, General practice utilization, Primary health",

author = "Louise Nissen and S{\o}by, {Jacob Hartmann} and {de Thurah}, Annette and Eva Prescott and Anders Prior and Simon Winther and Morten B{\o}ttcher",

note = "{\textcopyright} The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.",

year = "2024",

month = nov,

day = "1",

doi = "10.1093/ehjqcco/qcad074",

language = "English",

volume = "10",

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Nissen, L , Søby, JH , de Thurah, A, Prescott, E, Prior, A , Winther, S & Bøttcher, M 2024, 'Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population', European heart journal - Quality of care & clinical outcomes, vol. 10, no. 7, pp. 623-631. https://doi.org/10.1093/ehjqcco/qcad074

Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population. / Nissen, Louise ; Søby, Jacob Hartmann ; de Thurah, Annette et al.
In: European heart journal - Quality of care & clinical outcomes, Vol. 10, No. 7, 01.11.2024, p. 623-631.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population

AU - Nissen, Louise

AU - Søby, Jacob Hartmann

AU - de Thurah, Annette

AU - Prescott, Eva

AU - Prior, Anders

AU - Winther, Simon

AU - Bøttcher, Morten

N1 - © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.

PY - 2024/11/1

Y1 - 2024/11/1

N2 - Background Most patients undergoing coronary computed tomography angiography (CCTA) to diagnose coronary artery disease (CAD) are referred from general practitioners (GPs).The burden of contacts to GP in relation to investigation of suspected CAD is unknown. Methods and All patients undergoing CCTA in Western Denmark from 2014 to 2022 were included.CCTA stenosis was defined results as diameter stenosis of ≥50%.Patients with and without stenosis were matched, in each group, 1:5 to a reference population based on birth year, gender, and municipality using data from national registries.All GP visits were registered up to 5 years preceding and 1 year after the CTA and stratified by gender and age.Charlson comorbidity index (CCI) was calculated in all groups.Of the 62 512 patients included, 12 886 had a stenosis, while 49 626 did not.Patients in both groups had a substantially higher GP visit frequency compared with reference populations.In the year of coronary CTA, the median GP contacts in patients with stenosis were 11 (6-17) vs.6 (2-11) in the reference population (P < 0.001), and in patients without stenosis, the median GP contacts were 10 (6-17) vs.5 (2-11) (P < 0.001).These findings were consistent across age and gender.CCI was higher among both patients with and without stenosis compared with reference groups. Conclusion In patients undergoing CCTA to diagnose CAD, a substantially increased frequency of contacts to GP was observed in the 5-year period prior to examination compared with the reference populations, regardless of the CCTA findings.Obtaining the CCTA result did not seem to substantially affect the GP visit frequency.Graphical Patients undergoing coronary CTA due to symptoms suggestive of chronic coronary syndrome have an increased use Abstract visits to general practitioners in a 5 year period prior to examination, compared to a reference population.

AB - Background Most patients undergoing coronary computed tomography angiography (CCTA) to diagnose coronary artery disease (CAD) are referred from general practitioners (GPs).The burden of contacts to GP in relation to investigation of suspected CAD is unknown. Methods and All patients undergoing CCTA in Western Denmark from 2014 to 2022 were included.CCTA stenosis was defined results as diameter stenosis of ≥50%.Patients with and without stenosis were matched, in each group, 1:5 to a reference population based on birth year, gender, and municipality using data from national registries.All GP visits were registered up to 5 years preceding and 1 year after the CTA and stratified by gender and age.Charlson comorbidity index (CCI) was calculated in all groups.Of the 62 512 patients included, 12 886 had a stenosis, while 49 626 did not.Patients in both groups had a substantially higher GP visit frequency compared with reference populations.In the year of coronary CTA, the median GP contacts in patients with stenosis were 11 (6-17) vs.6 (2-11) in the reference population (P < 0.001), and in patients without stenosis, the median GP contacts were 10 (6-17) vs.5 (2-11) (P < 0.001).These findings were consistent across age and gender.CCI was higher among both patients with and without stenosis compared with reference groups. Conclusion In patients undergoing CCTA to diagnose CAD, a substantially increased frequency of contacts to GP was observed in the 5-year period prior to examination compared with the reference populations, regardless of the CCTA findings.Obtaining the CCTA result did not seem to substantially affect the GP visit frequency.Graphical Patients undergoing coronary CTA due to symptoms suggestive of chronic coronary syndrome have an increased use Abstract visits to general practitioners in a 5 year period prior to examination, compared to a reference population.

KW - Chronic coronary syndrome

KW - Coronary computed tomography angiography

KW - Coronary stenosis

KW - General practice utilization

KW - Primary health

UR - http://www.scopus.com/inward/record.url?scp=85208688175&partnerID=8YFLogxK

U2 - 10.1093/ehjqcco/qcad074

DO - 10.1093/ehjqcco/qcad074

M3 - Journal article

C2 - 38171498

SN - 2058-1742

VL - 10

SP - 623

EP - 631

JO - European heart journal - Quality of care & clinical outcomes

JF - European heart journal - Quality of care & clinical outcomes

IS - 7

ER -

Contact with general practice in patients with suspected chronic coronary syndrome before and after CT angiography compared with the general population

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