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Open Access 01-12-2021 | Arterial Diseases | Original Article

The impact and challenges of implementing CTCA according to the 2019 ESC guidelines on chronic coronary syndromes: a survey and projection of CTCA services in the Netherlands

Authors: T. P. W. van den Boogert, B. E. P. M. Claessen, S. M. Boekholdt, T. Leiner, R. Vliegenthart, S. F. Schuiling, J. R. Timmer, S. C. A. M. Bekkers, M. Voskuil, H. J. Siebelink, W. van Es, H. J. Lamb, M. Prokop, P. Damman, J. Stoker, H. C. Willems, J. P. Henriques, R. N. Planken

Published in: Insights into Imaging | Issue 1/2021

Abstract

Background

The 2019 ESC-guidelines on chronic coronary syndromes (ESC-CCS) recommend computed tomographic coronary angiography (CTCA) or non-invasive functional imaging instead of exercise ECG as initial test to diagnose obstructive coronary artery disease. Since impact and challenges of these guidelines are unknown, we studied the current utilisation of CTCA-services, status of CTCA-protocols and modeled the expected impact of these guidelines in the Netherlands.

Methods and results

A survey on current practice and CTCA utilisation was disseminated to every Dutch hospital organisation providing outpatient cardiology care and modeled the required CTCA capacity for implementation of the ESC guideline, based on these national figures and expert consensus. Survey response rate was 100% (68/68 hospital organisations). In 2019, 63 hospital organisations provided CTCA-services (93%), CTCA was performed on 99 CTCA-capable CT-scanners, and 37,283 CTCA-examinations were performed. Between the hospital organisations, we found substantial variation considering CTCA indications, CTCA equipment and acquisition and reporting standards. To fully implement the new ESC guideline, our model suggests that 70,000 additional CTCA-examinations would have to be performed in the Netherlands.

Conclusions

Despite high national CTCA-services coverage in the Netherlands, a substantial increase in CTCA capacity is expected to be able to implement the 2019 ESC-CCS recommendations on the use of CTCA. Furthermore, the results of this survey highlight the importance to address variations in image acquisition and to standardise the interpretation and reporting of CTCA, as well as to establish interdisciplinary collaboration and organisational alignment.

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Title: The impact and challenges of implementing CTCA according to the 2019 ESC guidelines on chronic coronary syndromes: a survey and projection of CTCA services in the Netherlands
Authors: T. P. W. van den Boogert
B. E. P. M. Claessen
S. M. Boekholdt
T. Leiner
R. Vliegenthart
S. F. Schuiling
J. R. Timmer
S. C. A. M. Bekkers
M. Voskuil
H. J. Siebelink
W. van Es
H. J. Lamb
M. Prokop
P. Damman
J. Stoker
H. C. Willems
J. P. Henriques
R. N. Planken
Publication date: 01-12-2021
Publisher: Springer International Publishing
Keyword: Arterial Diseases
Published in: Insights into Imaging / Issue 1/2021
Electronic ISSN: 1869-4101
DOI: https://doi.org/10.1186/s13244-021-01122-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact and challenges of implementing CTCA according to the 2019 ESC guidelines on chronic coronary syndromes: a survey and projection of CTCA services in the Netherlands

Abstract

Background

Methods and results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods and results

Conclusions

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