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Title: Cardiac computerised tomography for the assessment of pain and plaque : the CAPP study
Author: McKavanagh, Peter
ISNI:       0000 0004 6060 106X
Awarding Body: Queen's University Belfast
Current Institution: Queen's University Belfast
Date of Award: 2016
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The CAPP study involved 500 patients with stable chest pain who were randomised in an equal fashion to either EST or cardiac computerised tomography (CT) for assessment of significant coronary artery disease (CAD). These investigations were performed at baseline with follow up of patients involving both symptoms and clinical events over a one year period. Symptoms were assessed through the Seattle Angina Questionnaire (SAQ) at various time points over the course of a 12 month period, with the primary outcome being the change in symptoms as measured by change in SAQ scores over 90 days. The main results of the clinical part of the study were that patients in the CT arm had less angina as evident by the SAQ scores; less hospital re-attendances; less secondary tests and time to reach diagnosis and management; and had more revascularisations. Also as part of the study each patient had their pre-test probability of significant CAD calculated through the NICE modified Diamond Forrester (DF) Score. The accuracy of this in predicting significant CAD was compared to the accuracy of CS. The results of this sub­study were that patients with suspected stable CAD were more accurately risk stratified by CS compared to the traditional DF. A further sub-study involved the use of one of the techniques used to reduce radiation from CT, iterative reconstruction (IR). This is a means of improving image quality (or reduce radiation required) by using iterative algorithms to reconstruct the image data. This work was an assessment of the introduction of IR to the radiation exposure received by patients, showing that IR in cardiac CT offered substantial radiation reduction without compromise in image quality.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available