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Int J Cardiol. 2019 Mar 1;278:14-21. doi: 10.1016/j.ijcard.2018.09.094. Epub 2018 Oct 1.

General practice preventive health care in non-obstructive coronary artery disease determined by coronary computed tomography angiography.

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Department of Cardiology, Aarhus University Hospital, Denmark. Electronic address:
Department of Cardiology, Aarhus University Hospital, Denmark.
Section of General Practice, Department of Public Health, Aarhus University, Denmark; Department of Clinical Medicine, Diagnostic Center-Silkeborg, Aarhus University, Denmark.
Department of Clinical Epidemiology, Aarhus University Hospital, Denmark.



The aim of this study was to compare changes in health service utilization, preventive medical management, and cholesterol levels in patients without coronary artery disease (CAD) or with non-obstructive CAD as determined by coronary computed tomography angiography (CTA).


Single-center five-year observational registry-based cohort study of consecutive patients with chest pain undergoing coronary CTA with subsequent 12 months follow-up in general practice.


We included 3032 patients with a normal test result (n = 2179) or a diagnosis of non-obstructive CAD (n = 853) by coronary CTA. Median age was 55 (interquartile range: 47-63) years and 44% were males. After coronary CTA, the probability of a decrease in consultations with general practitioner was higher in patients with no CAD compared to patients with non-obstructive CAD (adjusted OR = 0.81 [95% CI: 0.68-0.96], P = 0.016). Accordingly, patients with non-obstructive CAD more frequently received prescriptions on lipid-lowering medical therapy (adjusted OR = 4.50 [95% CI: 3.31-6.12], P < 0.001) than patients with no CAD after coronary CTA. In patients with non-obstructive CAD, mean total-cholesterol reduction was 0.51 (P < 0.001) compared to 0.13 mmol/L (P < 0.001) in patients without non-obstructive CAD. The relative reduction in low-density lipoprotein was 14% higher (P < 0.001) in patients with compared to patients without non-obstructive CAD after coronary CTA.


Coronary CTA with subsequent follow-up in general practice has the potential to align health service utilization that prioritizes high-risk patients and facilitate optimized preventive management.


Atherosclerosis; Coronary computed tomography angiography; General practice; Health service utilization; Management; Preventive

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