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Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial

Overview of attention for article published in British Medical Journal, October 2016
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (90th percentile)

Mentioned by

news
5 news outlets
blogs
2 blogs
twitter
55 tweeters
facebook
8 Facebook pages
video
1 video uploader

Citations

dimensions_citation
42 Dimensions

Readers on

mendeley
93 Mendeley
Title
Evaluation of computed tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial
Published in
British Medical Journal, October 2016
DOI 10.1136/bmj.i5441
Pubmed ID
Authors

Marc Dewey, Matthias Rief, Peter Martus, Benjamin Kendziora, Sarah Feger, Henryk Dreger, Sascha Priem, Fabian Knebel, Marko Böhm, Peter Schlattmann, Bernd Hamm, Eva Schönenberger, Michael Laule, Elke Zimmermann

Abstract

 To evaluate whether invasive coronary angiography or computed tomography (CT) should be performed in patients clinically referred for coronary angiography with an intermediate probability of coronary artery disease.  Prospective randomised single centre trial.  University hospital in Germany.  340 patients with suspected coronary artery disease and a clinical indication for coronary angiography on the basis of atypical angina or chest pain.  168 patients were randomised to CT and 172 to coronary angiography. After randomisation one patient declined CT and 10 patients declined coronary angiography, leaving 167 patients (88 women) and 162 patients (78 women) for analysis. Allocation could not be blinded, but blinded independent investigators assessed outcomes.  The primary outcome measure was major procedural complications within 48 hours of the last procedure related to CT or angiography.  Cardiac CT reduced the need for coronary angiography from 100% to 14% (95% confidence interval 9% to 20%, P<0.001) and was associated with a significantly greater diagnostic yield from coronary angiography: 75% (53% to 90%) v 15% (10% to 22%), P<0.001. Major procedural complications were uncommon (0.3%) and similar across groups. Minor procedural complications were less common in the CT group than in the coronary angiography group: 3.6% (1% to 8%) v 10.5% (6% to 16%), P=0.014. CT shortened the median length of stay in the angiography group from 52.9 hours (interquartile range 49.5-76.4 hours) to 30.0 hours (3.5-77.3 hours, P<0.001). Overall median exposure to radiation was similar between the CT and angiography groups: 5.0 mSv (interquartile range 4.2-8.7 mSv) v 6.4 mSv (3.4-10.7 mSv), P=0.45. After a median follow-up of 3.3 years, major adverse cardiovascular events had occurred in seven of 167 patients in the CT group (4.2%) and six of 162 (3.7%) in the coronary angiography group (adjusted hazard ratio 0.90, 95% confidence interval 0.30 to 2.69, P=0.86). 79% of patients stated that they would prefer CT for subsequent testing. The study was conducted at a University hospital in Germany and thus the performance of CT may be different in routine clinical practice. The prevalence was lower than expected, resulting in an underpowered study for the predefined primary outcome.  CT increased the diagnostic yield and was a safe gatekeeper for coronary angiography with no increase in long term events. The length of stay was shortened by 22.9 hours with CT, and patients preferred non-invasive testing.Trial registration ClinicalTrials.gov NCT00844220.

Twitter Demographics

The data shown below were collected from the profiles of 55 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 93 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 1%
Czechia 1 1%
Germany 1 1%
Unknown 90 97%

Demographic breakdown

Readers by professional status Count As %
Student > Master 15 16%
Student > Ph. D. Student 12 13%
Other 11 12%
Student > Bachelor 8 9%
Student > Postgraduate 6 6%
Other 21 23%
Unknown 20 22%
Readers by discipline Count As %
Medicine and Dentistry 53 57%
Engineering 4 4%
Computer Science 2 2%
Nursing and Health Professions 2 2%
Economics, Econometrics and Finance 1 1%
Other 2 2%
Unknown 29 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 86. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 November 2017.
All research outputs
#268,597
of 16,336,603 outputs
Outputs from British Medical Journal
#3,855
of 50,492 outputs
Outputs of similar age
#8,956
of 296,549 outputs
Outputs of similar age from British Medical Journal
#84
of 841 outputs
Altmetric has tracked 16,336,603 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 50,492 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 36.4. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 296,549 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 841 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 90% of its contemporaries.