| Usefulness of 64-slice multidetector computed tomography in diagnostic triage of patients with chest pain and negative or nondiagnostic exercise treadmill test result. | |
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MedLine Citation:
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PMID: 17398185 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The usefulness of 64-slice multidetector coronary computed tomography (MDCT) in a diagnostic triage of 100 consecutive patients (age 55.8+/-11.6 years; 57% men) with chest pain suspected to be ischemic in origin and a negative or nondiagnostic exercise treadmill test (ETT) result was examined. None of the patients had previously known coronary artery disease (CAD). MDCT showed obstructive (>or=50%) CAD in 29 patients; 13 of 59 patients (22%) with a negative and 16 of 41 patients (39%) with a nondiagnostic ETT result. High-risk (left main and/or 3-vessel) CAD was present in 3.3% of patients with a negative and 4.9% with a nondiagnostic ETT result. The 29 patients with obstructive CAD on MDCT had a higher mean Agatston calcium score (221+/-402 vs 40+/-77 U, p<0.001). Invasive coronary angiography confirmed MDCT findings in 26 of 29 patients (positive predictive value 90%) and 45 of 54 stenotic segments (83%) in a per-segment analysis. For the 71 patients without obstructive CAD on MDCT, clinically driven invasive angiography detected CAD in 1 of 15 patients (1 false-negative MDCT result) and 2 of another 5 patients who were referred for invasive angiography later during a 12-month follow-up period. In the remaining 51 patients, MDCT findings effectively allowed exclusion of obstructive CAD, and there were no major adverse clinical events during follow-up. In conclusion, in patients with chest pain possibly ischemic in origin, no previously known CAD, and a negative or nondiagnostic ETT result, contrast-enhanced 64-slice MDCT scanning was a useful tool to provide direct noninvasive coronary angiography and rapidly advance diagnostic triage. |
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Authors:
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Ronen Rubinshtein; David A Halon; Tamar Gaspar; Jorge E Schliamser; Nisan Yaniv; Ronny Ammar; Moshe Y Flugelman; Nathan Peled; Basil S Lewis |
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Publication Detail:
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Type: Journal Article Date: 2007-02-15 |
Journal Detail:
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Title: The American journal of cardiology Volume: 99 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-02 Completed Date: 2007-04-25 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 925-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiovascular Medicine, Lady Davis Carmel Medical Center, and Ruth and Bruce Rappaport School of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina Pectoris / etiology, pathology, radiography* Calcinosis / radiography Chest Pain / etiology, pathology, radiography* Coronary Angiography Coronary Artery Disease / complications, pathology, radiography Coronary Stenosis / complications, pathology, radiography Exercise Test* False Negative Reactions False Positive Reactions Female Follow-Up Studies Humans Male Middle Aged Predictive Value of Tests Retrospective Studies Severity of Illness Index Tomography, X-Ray Computed* Triage* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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