Round-the-clock performance of coronary CT angiography for suspected acute coronary syndrome: Results from the BEACON trial

Objective: To assess the image quality of coronary CT angiography (CCTA) for suspected acute coronary syndrome (ACS) outside office hours. Methods: Patients with symptoms suggestive of an ACS underwent CCTA at the emergency department 24 hours, 7 days a week. A total of 118 patients, of whom 89 (75 %) presented during office hours (weekdays between 07:00 and 17:00) and 29 (25 %) outside office hours (weekdays between 17:00 and 07:00, weekends and holidays) underwent CCTA. Image quality was evaluated per coronary segment by two experienced readers and graded on an ordinal scale ranging from 1 to 3. Results: There were no significant differences in acquisition parameters, beta-blocker administration or heart rate between patients presenting during office hours and outside office hours. The median quality score per patient was 30.5 [interquartile range 26.0–33.5] for patients presenting during office hours in comparison to 27.5 [19.75–32.0] for patients presenting outside office hours (p=0.043). The number of non-evaluable segments was lower for patients presenting during office hours (0 [0–1.0] vs. 1.0 [0–4.0], p=0.009). Conclusion: Image quality of CCTA outside office hours in the diagnosis of suspected ACS is diminished. Key Points: • Quality scores were higher for coronary-CTA during office hours.• There were no differences in acquisition parameters.• There was a non-significant trend towards higher heart rates outside office hours.• Coronary-CTA on the ED requires state-of-the-art scanner technology and sufficiently trained staff.• Coronary-CTA on the ED needs preparation time and optimisation o

Screening for coronary artery calciumin a high-risk population: the ROBINSCA trial

Cardiolog

Methodological aspects of blood pressure measurement and adherence to antihypertensive drug therapy.

Contains fulltext : 53625.pdf (publisher's version ) (Open Access)Hypertension is an important risk-factor for cardiovascular disease. Accurate blood pressure measurements are very important to diagnose hypertension. Nowadays these blood pressure measurements are often performed using automatic devices. One can wonder whether these devices are accurate enough. In this thesis an automatic upper-arm device and wrist-device are tested. The consequences of the accuracy of these devices for the diagnosis and treatment of hypertension are discussed. Hypertension is a largely asymptomatic condition for which life-long drug treatment is often necessary. For adequate treatment of hypertension adherence to antihypertensive drugs is essential. Objective methods to measure drug adherence are currently lacking. In this thesis the measurement of bromide added to antihypertensive drugs is used to measure adherence. The advantages and disadvantages of this method are discussed.RU Radboud Universiteit Nijmegen, 31 januari 2007Promotores : Thien, Th., Lenders, J.W.M.177 p

The influence of the method of data analysis on the reported accuracy of automated blood pressure measuring devices.

OBJECTIVE: To show that different methods of data analysis affect the grading that blood pressure measuring devices achieve according to the British Hypertension Society (BHS)-protocol. METHODS: Based on the somewhat unclear description of the exact method of data analysis in the BHS-protocol four different methods can be discerned. The effect on the grading-results is calculated for these four different options. RESULTS AND CONCLUSIONS: It is shown that using these four different options the achieved grade can range for diastolic blood pressure from C (option 1) to almost A (option 4) and for systolic blood pressure from D (option 1) to B (option 4). Different researchers may well have used different methods. Option 1 is the method that should be used. Also it is stated that the systematic error and the standard deviation of differences (SDD) are measures that give more insight to describe a device's performance. Calculating the grades after correction for the systematic error shows its influence and that of the SDD on the reported accuracy of a blood pressure measuring device