Study intriguing but not definitive
In a panel discussion that followed the presentation of these results at the meeting, sponsored by the Cardiovascular Research Foundation, some reservations with this study were expressed. In particular, several of the panelists, including Jeffrey W. Moses, MD, director of interventional cardiovascular therapeutics, Columbia University Medical Center, New York, expressed surprise at the 27% rate of CIN, which he considered uncommonly high even in a high-risk population.
The unusual rate of CIN was also considered problematic given that it was the most significant clinical outcome among the three co–primary endpoints. Procedural times and patient satisfaction, while valid endpoints, are important subjects of study, but Dr. Moses was not alone in suggesting this study deserves validation.
In particular, there appeared to be a consensus among panelists that a larger multicenter study looking at hard endpoints, such as MACE, would be more compelling. They indicated that even if CTCA poses a very low risk of meaningful complications, it does add expense and an extra step.
Dr. Jones reported no potential conflicts of interest. Dr. Moses reported financial relationships with Covanos, Orchestra Biomed, Ostial, and Xenter.