Search

Introduction: Invasive coronary angiography (ICA) is associated with higher complication rates in patients following coronary artery bypass surgery (CABG). CT coronary angiography (CTCA) has emerged as an attractive alternative. We assessed the impact of CTCA on subsequent ICA., Methods: We identified 213 CABG patients undergoing CTCA between 2015 and 2018. In 151 the indication was suspected recurrence of angina. We then identified patients undergoing ICA within 1 year of CTCA., Results: CTCA obviated the need for ICA in 115 cases (76%). CTCA was better at identifying targets for percutaneous coronary intervention (PCI) to saphenous vein grafts (SVG's) than to native vessels (89% vs 47%). 7 out of 10 lesions of "probable" significance by CTCA proved flow-limiting, and 4 out of 13 "indeterminate" lesions. CTCA concordance was 97% for left internal mammary (LIMA) grafts., Conclusion: CTCA directed management in a majority of patients without ICA. It identified a cohort of patients likely to be candidates for SVG PCI, but was less effective in identifying PCI targets in the native vessels. CTCA renders invasive LIMA cannulation redundant unless a target lesion is suspected.

Aims: We aimed to assess the scale of the problem of illiteracy among our hospital's general medical in-patients and investigate any influence on literacy from gender, age, socioeconomic status, disease process and number of prescribed medications., Methods: We employed a shortened version of the previously validated Rapid Estimate of Adult Literacy in Medicine (REALM) tool with medical in-patients at Glasgow Royal Infirmary. We also recorded gender, date of birth and clinical problem. Socioeconomic status was estimated from the patient's postcode using the Scottish Index of Multiple Deprivation (SIMD)., Results: 60 patients were invited to participate, however six (10%) declined. We therefore gathered data for 54 patients (54% male) with a mean age of 67 years. The female group had a significantly higher mean age of 73 years versus 62 years in men. The mean SIMD quintile was 3.5 (1 least deprived, 5 most deprived) and the mean number of medications was 7.55% of our patients had a mean score of < 60 which represents low health literacy. There were no significant differences in literacy between men (median score 59) and women (median score 60). Reading ability was not found to be associated with socioeconomic group, diseased body system or number of medications on the drug chart (data not shown)., Conclusions: Low level health literacy is prevalent. Affected individuals may have difficulty understanding patient-orientated health literature, medication instructions, clinic appointment cards and hospital signage.