Document Detail


Multislice computed tomography coronary angiography in patients admitted with a suspected acute coronary syndrome.
MedLine Citation:
PMID:  17164983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this prospective clinical study was to assess the accuracy and clinical relevance of multislice computed tomography coronary angiography (MSCTCA) in patients presenting with acute chest pain. BACKGROUND: Multislice computed tomography coronary angiography has shown ability to detect accurately coronary artery disease (CAD) in selected elective patient groups. METHODS: One hundred and twenty patients presenting with acute chest pain (<24 h) underwent MSCTCA (Siemens Sensation 16) before a scheduled inpatient conventional coronary angiogram (CCA). Exclusion criteria included patients with STEMI, non-sinus rhythm, contraindication to beta blockers and renal impairment. Blinded visual assessment of MSCTCA to detect CAD was performed on an 11-segment model. The accuracy of MSCTCA was compared to CCA to detect significant stenoses (> or =50%). RESULTS: One hundred and thirteen patients underwent both investigations. The prevalence of significant CAD was 74%. 1,243 native segments were assessed by MSCTCA. The overall ability of MSCTCA to detect the presence of > or =1 significant stenosis in all native segments had a sensitivity of 92% (95%CI 83-97%), specificity of 55% (95%CI 35-74%), positive predictive value of 86% (95%CI 76-93%) and negative predictive value of 70% (95%CI 47-87%). 22% of all segments (mostly distal) were non-analyzable. Coronary calcification was a major cause of false positivity. CONCLUSION: In a prospective study of unselected patients presenting with acute chest pain, the diagnostic accuracy of 16-slice CT coronary angiography was moderate and less than reported from studies in elective patients. The clinical relevance of this technology to screen patients with acute chest pain is limited.
Authors:
Duncan R Coles; Peter Wilde; Martin Oberhoff; Chris A Rogers; Karl R Karsch; Andreas Baumbach
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-12-13
Journal Detail:
Title:  The international journal of cardiovascular imaging     Volume:  23     ISSN:  1569-5794     ISO Abbreviation:  Int J Cardiovasc Imaging     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-17     Completed Date:  2007-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100969716     Medline TA:  Int J Cardiovasc Imaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  603-14     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Bristol Royal Infirmary, Bristol BS2 8HW, UK.
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / complications*,  epidemiology,  etiology,  radiography
Adult
Aged
Aged, 80 and over
Angina Pectoris / epidemiology,  etiology*,  radiography
Calcinosis / epidemiology,  radiography*
Coronary Angiography / methods*
Coronary Stenosis / complications,  epidemiology,  radiography*
False Positive Reactions
Female
Humans
Male
Middle Aged
Pilot Projects
Predictive Value of Tests
Prevalence
Prospective Studies
Reproducibility of Results
Research Design
Sensitivity and Specificity
Severity of Illness Index
Tomography, X-Ray Computed*
Comments/Corrections
Comment In:
Int J Cardiovasc Imaging. 2007 Oct;23(5):615-6   [PMID:  17703293 ]

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