Temporal trend and regional disparity in the investigations for stable chest pain in Europe: An insight from the PIONEER IV trial.

Coronary CT angiography (CCTA) and fractional flow reserve with CCTA (FFRCT) have been endorsed by the ACC/AHA Chest Pain guidelines to streamline the diagnosis of coronary artery disease (CAD), but there is still a significant lack of adherence. In our study of 673 stable chest patients without known CAD from 5 European countries, we found that CCTA is the most common noninvasive diagnostic test, but nearly 40 ​% of them still underwent upfront CAD. Additionally, there was no temporal improvement trend, and the integration of FFRCT is low. We highlighted the urgent need to improve diagnostic processes and update reimbursement policies.

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Copyright © 2024 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare the following financial interests/personal relationships, which may be considered as potential competing interests: Patrick W. Serruys reports a relationship with Sino Medical Sciences Technology Inc. that includes funding grants. Patrick W. Serruys reports a relationship with Sahajanand Medical Technologies Pvt Ltd that includes: funding grants. Patrick W. Serruys reports a relationship with Philips Medical Systems Nederland BV that includes: funding grants. Patrick W. Serruys reports a relationship with Xeltis BV that includes: funding grants. Scot Garg reports a relationship with Biosensors Europe SA that includes: consulting or advisory. Thomas F Luscher reports a relationship with Abbott Cardiovascular that includes: funding grants. Thomas F. Luscher reports a relationship with Amgen Europe GmbH that includes: funding grants. Thomas F. Luscher reports a relationship with AstraZeneca Pharmaceuticals LP that includes: funding grants. Thomas F. Luscher reports a relationship with Boehringer Ingelheim GmbH that includes: funding grants. Thomas F. Luscher reports a relationship with Daiichi Sankyo Inc that includes: funding grants. Thomas F. Luscher reports a relationship with Eli Lilly and Company that includes: funding grants. Thomas F. Luscher reports a relationship with Novartis Pharmaceuticals Corporation that includes: funding grants. Thomas F. Luscher reports a relationship with Novo Nordisk Inc that includes: funding grants. Thomas F. Luscher reports a relationship with Sanofi SA that includes: funding grants. Thomas F. Luscher reports a relationship with Vifor (International) AG that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.