Rajeev Gupta, MD; Wael Almahmeed, MD
Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterest Forms.do?msNum=L15-0479.
Gupta R, Almahmeed W. Coronary Computed Tomography Angiography Versus Radionuclide Myocardial Perfusion Imaging. Ann Intern Med. 2016;164:133. doi: 10.7326/L15-0479
Download citation file:
Published: Ann Intern Med. 2016;164(2):133.
TO THE EDITOR:
Levsky and colleagues' study (1) is important because it has a mean follow-up of 40.4 months. Although short- and intermediate-term outcome studies have shown similar outcomes with 2 diagnostic methods (CCTA and physiologic testing) (2), there is an impending need for randomized trials driven by long-term outcomes before a definite claim or conclusion about the superiority of one diagnostic technique can be confirmed. However, like previous studies (3), Levsky and colleagues' trial did not include patients treated with medical therapy only without undergoing testing. Data from these patients would be useful because we still do not know whether any interventions that are guided by positive test results decrease event rates. The results of the ongoing ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches), in which extensive ischemia found on functional testing guides randomized therapy (invasive vs. medical), will help us better understand this factor (4).
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only