Journal of the American College of Cardiology
Cardiac Imaging
Impact of a Continuous Quality Improvement Initiative on Appropriate Use of Coronary Computed Tomography AngiographyResults From a Multicenter, Statewide Registry, the Advanced Cardiovascular Imaging Consortium
Kavitha M. Chinnaiyan, Patricia Peyser, Tauqir Goraya, Karthikeyan Ananthasubramaniam, Michael Gallagher, Ann DePetris, Judith A. Boura, Ella Kazerooni, Chad Poopat, Mouaz Al-Mallah, Souheil Saba, Smita Patel, Steven Girard, Thomas Song, David Share and Gilbert Raff
Table 1
Table 1
Clinical Characteristics of Study Group
| Pre-Intervention (n = 5,993) | Intervention (n = 15,396) | Follow-Up (n = 3,302) | p Value | |
|---|---|---|---|---|
| Age (yrs) | 57 ± 13 | 58 ± 13 | 57 ± 14 | 0.20 |
| Male | 3,229 (54%) | 8,152 (53%) | 1,796 (54%) | 0.76 |
| Prior CAD | 1,371 (23%) | 3,460 (22%) | 679 (21%) | 0.010 |
| Smoking | 875 (14.8%) | 2,260 (14.7%) | 511 (15.5%) | 0.029 |
| Family history of premature CAD | 2,637 (44%) | 5,850 (38%) | 1,288 (39%) | <0.0001 |
| Diabetes | 889 (15%) | 2,549 (17%) | 545 (17%) | 0.042 |
| Hypertension | 3,036 (51%) | 8,407 (55%) | 1,876 (57%) | <0.0001 |
| Hyperlipidemia | 3,416 (57%) | 9,238 (60%) | 2,047 (62%) | <0.0001 |
| Peripheral vascular disease | 186 (3.1%) | 539 (3.5%) | 142 (4.3%) | 0.0022 |
| Chronic obstructive lung disease | 270 (4.5%) | 1,078 (7.0%) | 334 (10.1%) | <0.0001 |
| Framingham risk | <0.0001 | |||
| Low | 3,500 (58.4%) | 8,345 (54.2%) | 1,737 (52.6%) | |
| Intermediate | 2,020 (33.7%) | 5,496 (35.7%) | 1,182 (35.8%) | |
| High | 473 (7.9%) | 1,555 (10.1%) | 383 (11.6%) | |
| Pre-test likelihood of CAD | <0.0001 | |||
| Low | 1,726 (28.8%) | 4,157 (27%) | 842 (25.5%) | |
| Intermediate | 3,602 (60.1%) | 9,730 (63.2%) | 2,236 (67.7%) | |
| High | 665 (11.1%) | 1,509 (9.8%) | 221 (6.7%) | |
| Stenosis on CCTA | 0.041 | |||
| 0 (normal coronary arteries) | 2,403 (40.1%) | 6,513 (42.3%) | 1,407 (42.6%) | |
| <50% | 2,014 (33.6%) | 4,819 (31.3%) | 1,030 (31.2%) | |
| >50% | 1,576 (26.3%) | 4,049 (26.3%) | 865 (26.2%) | |
| Referral status | 0.0003 | |||
| Inpatient | 725 (12.1%) | 1,463 (9.5%) | 433 (13.1%) | |
| Emergency department | 1,193 (19.9%) | 2,526 (16.4%) | 546 (16.5%) | |
| Outpatient | 4,075 (68.0%) | 11,408 (74.1%) | 2,325 (70.4%) |
Values are mean ± SD or n (%). *The p value comparing pre-intervention with follow-up periods.
CAD = coronary artery disease; CCTA = coronary computed tomography angiography.
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