Coronary computed tomography angiography – Tolerability of β-blockers and contrast media, and temporal changes in radiation dose

Figures & data

Figure 1. Questionnaire regarding adverse effects of β-blockers.

Table I. Characteristics of participants.

Variable	Participants (n = 416)*
Age, mean (± SD; min-max)	57 (± 11; 29–87)
Gender, male n (%)	201 (48%)
Smoking
Current, n (%)	91 (22%)
Previously, n (%)	174 (42%)
Never, n (%)	144 (35%)
Family history of cardiovascular disease, n (%)	194 (47%)
Symptoms	109 (26%)
Typical angina pectoris, n (%)	136 (33%)
Atypical angina pectoris, n (%)	145 (35%)
Non-cardiac angina pectoris, n (%)	26 (6%)
Unknown, n (%)
Diamond and Forrester (%), (n = 390), mean (± SD; min-max)	40 (± 23; 7–89)
BMI (kg/m^2), (n = 408), mean (± SD; min-max)	26.7 (± 4;17.8–42.1)
Heart rate prior to CCTA (beat/min), (n = 407), mean (± SD; min-max)	65 (± 12; 30–141)
Systolic blood pressure (mmHg), (n = 408), mean (± SD; min-max)	145 (± 20; 87–222)
Total cholesterol (mmol/L), (n = 384), mean, (± SD; min-max)	5.3 (± 1.0; 4.0–7.6)
Creatinine prior to CCTA (μmol/L), (n = 408), mean (± SD; min-max)	76 (± 16; 38–148)
eGFR prior to CCTA (mL/min), (n = 408), mean (± SD; min-max)	79 (± 11; 36–90)
Preexisting morbidity
Hypertension, medically treated, n (%)	169 (41%)
Diabetes Mellitus, n (%)	26 (6%)
Ejection fraction (%), (n = 337), mean (± SD; min-max)	58 (± 6; 10–70)
Ejection fraction < 50%, n (%)	13 (3%)
Atrial fibrillation, previously, n (%)	72 (17%)
Apoplexy (TCI), previously, n (%)	25 (6%)
Peripheral artery disease, previously, n (%)	2 (0.5%)
Pharmacological treatment	180 (43%)
Acetylsalicylic acid, n (%)	19 (5%)
Anticoagulants, n (%)	75 (18%)
β-blockers, n (%)	53 (13%)
Calcium-channel-inhibitors, n (%)	12 (3%)
Nitroglycerin, n (%)	102 (25%)
ACE/Angiotensinogen-II-inhibitors, n (%)	33 (8%)
Loop-diuretics, n (%)	40 (10%)
Thiazide diuretics, n (%)	121 (29%)
Statins, n (%)	17 (4%)
Peroral anti-diabetics, n (%)	7 (2%)
Insulin, n (%)

CCTA, Coronary computed tomography angiography.

*Unless otherwise noted. BMI, Body Mass Index.

Table II. Possible side effects of β-blocker pretreatment.

	Total	β-blocker pretreatment		p value
		Yes	No
Dizziness (n = 205)	24/205 (12%)	21/176 (12%)	3/29 (10%)	0.5
Lipothymia (n = 245)	2/245 (0.8%)	1/213 (0.5%)	1/32 (3%)	0.2
Tachycardia (n = 186)	8/186 (4%)	7/162 (4%)	1/24 (4%)	0.7
Total no. of adverse effects (n = 248)	31/248 (13%)	26/216 (12%)	5/32 (16%)	0.4

Table III. Baseline post-procedural levels of s-creatinine and eGFR.

	pre-CCTA	post-CCTA	p value
All patients (n = 273)
s-creatinine (μmol/L), mean (± SD; min-max)	75 (± 16; 30–148)	75 (± 16; 37–129)	p = 0.09
eGFR (mL/min) mean (± SD; min-max)	78 (± 11; 36–90)	79 (± 11; 41–90)	p = 0.17
Patients with diabetes mellitus (n = 20)
s-creatinine (μmol/L), mean (± SD; min-max)	78 (± 24; 51–127)	72 (± 19; 47–112)	p = 0.03
eGFR (mL/min) mean (± SD; min-max)	78 (± 18; 36–90)	82 (± 15; 41–90)	p = 0.05
Patients with impaired renal function (n = 16)
s-creatinine (μmol/L), mean (± SD; min-max)	108 (± 20; 83–148)	96 (± 17; 75–129)	p = 0.004
eGFR (mL/min) mean (± SD; min-max)	50 (± 7; 36–59)	58 (± 12; 41–72)	p = 0.01

eGFR, estimated GFR.

Figure 2. Box plot of radiation exposure. The box represents the 25th and 75th percentile; the middle line represents the median and the peripheral lines extend to the outer fences which are 1.5 times the interquartile range below and above the 25th and 75th percentile, respectively. The dots are outliers.