Padrões de indicação da angiotomografia coronaria de múltiplos detectores na prática clínica: experiência de um centro de referência / Multidetector computed tomographic angiography of coronary arteries in daily clinical practice: experience of a tertiary center

RESUMO

INTRODUÇÃO: A angiotomografia coronária com múltiplos detectores está sendo progressivamente utilizada na prática clínica diária. Não existem estudos em nosso meio analisando o perfil dos pacientes submetidos a esse exame. Método: Estudo de coorte transversal, incluíndo pacientes submetidos a angiotomografia coronária com múltiplos detectores em um centro de referência por indicação de seu médico assistente. Antes da realização do exame, foram avaliadas a presença de fatores de risco, a apresentação clínica da doença arterial coronária e os exames diagnósticos não-invasivos e invasivos já realizados. Os dados foram analisados com o programa SPSS 13.0. Resultados: A média de idade dos 689 pacientes incluídos foi de 63,7 anos e 52 por cento eram do sexo masculino. Em relação aos fatores de risco, 65 por cento eram hipertensos...

ABSTRACT

BACKGROUND: Multidetector computed tomographic angiography of coronary arteries has been increasingly used in the daily clinical practice. There are no studies in Brazil analyzing the profile of patients submitted to this new test. METHOD: Cross-sectional cohort study including patients submitted to multidetector computed tomographic angiography at a reference center and referred by their attending physician. Before angiotomographic evaluation, patients were assessed for the presence of risk factors, clinical presentation and previous results of invasive and non-invasive tests. Data were analyzed using SPSS 13.0. RESULTS: Mean age of the 689 patients was 63.7 years and 52% were men. As to risk factors, 65% were hypertensive, 17% were diabetic, 9.6% were smokers, and 63% had family history of coronary artery disease. As to the clinical presentation of the disease, 49% were asymptomatic, 16% had atypical chest pain and 35% had angina. Twenty-five percent of the patients had echocardiography, 21% had myocardial scintigraphy and 37% had no previous tests. Less than 1% of the patients did not have any of these characteristics and most of them had three or more risk factors, frequently associated to abnormal diagnostic tests and prior myocardial revascularization. Among asymptomatic patients, 98% presented at least one of the risk factors and 27% had a previous positive test. CONCLUSION: Most of the patients referred for multidetector computed tomographic angiography in this sample had risk factors or previous diagnostic workup suggesting the presence of coronary artery disease.