{
  "abstract": "Background CT coronary angiography (CTCA) is a first-line investigation for stable chest pain. We audited CTCA practice at Hampshire Hospitals Foundation Trust to evaluate disease severity, radiation dose, HeartFlow FFR-CT use, and accuracy.Methods We performed a retrospective audit of 418 patients referred for CTCA; 14 were excluded, leaving 404 assessable scans. Data included demographics, cardiovascular risk factors, CTCA findings, dose-length product (DLP), HeartFlow use, and invasive angiography (IA). CTCA severity was categorised as normal, non-obstructive (minimal/mild), moderate, or severe. Diagnostic accuracy was assessed in patients undergoing IA, using ≥50% stenosis as the threshold for moderate and severe coronary artery disease. Concordance was defined as agreement in severity category between CTCA and IA; broad concordance was agreement in non-obstructive disease versus moderate-severe (figure 1).Results Mean age was 59.2 years, 53.2% were male, and 27% had ≥3 risk factors. Median DLP was 130.4 mGy·cm, with 90.6% of scans ≤380 mGy·cm. CTCA findings were normal in 43.6%, non-obstructive in 38.1%, moderate in 9.9%, and severe in 8.2%. HeartFlow was performed in 14.9% of patients, with 38.3% showing haemodynamically significant disease. IA was performed in 13.1%. Among 52 CTCA–IA comparisons, exact concordance was 53.8% and broad concordance 76.9%. In the IA subgroup, CTCA had a positive predictive value of 85.3% for moderate/severe disease (figures 2–16).Conclusions CTCA stratified CAD effectively with appropriate radiation exposure. It showed good positive predictive value and good concordance with IA, supporting its role as a useful diagnostic tool. HeartFlow provided additional functional assessment in selected patients. Findings were limited by retrospective design. Question:Which of the following statements is correct according to this audit of CTCA practice at HHFT?A. Severe CTCA disease was seen in more than 20% of patients, and HeartFlow was performed in over 50% of the cohort.B. The median DLP exceeded the UK coronary CTA reference level, and fewer than half of severe CTCA cases had a documented outcome.C. Normal or non-obstructive CTCA findings accounted for over 80% of scans, and 90.6% of scans had DLP ≤380 mGy·cm.D. Exact concordance between CTCA and invasive angiography exceeded 80% in patients undergoing both tests.E. All patients with CAD-RADS 3 or above underwent HeartFlow FFR-CT.Abstract 29 Figure 16CTCA compared to age groupAbstract 29 Figure 15Comorbidities and severity of CTCA findingsAbstract 29 Figure 14CTCA resultsAbstract 29 Figure 13Age of cohortAbstract 29 Figure 12Risk factor burdenAbstract 29 Figure 11Distribution of risk factorsAbstract 29 Figure 10DLP assessment to national standardAbstract 29 Figure 9Flow chartAbstract 29 Figure 8Analysis of outcomes based on CTCAAbstract 29 Figure 7CTCA went ahead for angioAbstract 29 Figure 6CTCA went ahead for angioAbstract 29 Figure 5HF comparison to CTCA reportAbstract 29 Figure 4Distribution of Total HF CT resultsAbstract 29 Figure 3CTCA progressed to HFAbstract 29 Figure 2CTCA scans sent for HF FFRAbstract 29 Figure 1CTCA indicationsCorrect answer: C",
  "authors": [
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Aristides Plastiras"
    },
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Priyanka Balasubramani"
    },
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Sarah Dalby"
    },
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Rachel Herbert"
    },
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Michael Li"
    },
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Oliver Lewis"
    },
    {
      "affiliations": [
        "Basingstoke North Hampshire Hospital"
      ],
      "name": "Laura Corsinovi"
    }
  ],
  "title": "29 Retrospective audit of CT coronary angiography at HHFT",
  "uid": "e779db6a-eb21-50a2-8a2c-1fa01286062a"
}