[Influence of coronary CT angiography findings on prevention strategies of coronary artery disease].

OBJECTIVE:To explore impact of coronary CT angiography findings on preventive medical treatment and control of coronary artery disease (CAD) risk factors. METHODS:Consecutive patients with atherosclerotic plaque detected by coronary CT angiography were enrolled in our study from September 2013 to December 2014, grouped as <50% stenosis and ≥ 50% stenosis.Baseline and follow-up data were recorded.Comparative analysis was performed both between stenosis groups and pre- and post-CT angiography data.Multivariable Logistic regression were preformed to investigate association between coronary CT angiography findings and subsequent medical therapies. RESULTS:Totally 160 patients were enrolled in our study, 99 were <50% stenosis and 61 were ≥ 50% stenosis.Significant reduction of total cholesterol (5.06 ± 1.04 vs 4.54 ± 1.09 mmol/L, P<0.01), low-density lipoprotein cholesterol (3.16 ± 0.95 vs 2.60 ± 0.88 mmol/L, P<0.01), and triglyceride (1.66 (1.14, 2.28) vs 1.55(1.07, 2.05) mmol/L, P=0.004) were observed Pre- versus post-CT angiography. Compared to patients with <50% stenosis, patients with ≥ 50% stenosis demonstrated more significant reduction with regard to total cholesterol (-0.70 ± 0.94 vs -0.42 ± 0.96 mmol/L, P=0.035) and low-density lipoprotein cholesterol (-0.78 ± 0.99 vs -0.43 ± 0.79 mmol/L, P=0.016). After CT angiography, aspirin (13.8% vs 65.6%, P<0.01) and statin (20.0% vs 71.9%, P<0.01) use were significantly increased, blood pressure medication (53.1% vs 63.1%, P=0.07) use showed no statistical differences. Adjusted for baseline risk factors and pretest medications, CT angiography findings were independently associated with increased post-CT angiography use of aspirin (adjusted OR (95% CI) : 3.58 (1.61-7.99), P=0.002) and statin (adjusted OR (95% CI) : 15.01 (4.40-51.22), P<0.01). CONCLUSION:Coronary CT angiography findings demonstrated direct impact on subsequent medical therapies and control of CAD risk factors, and offered important guidance for prevention strategies of CAD.