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Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study.

Abstract：

OBJECTIVE:Our two-centre prospective study evaluates the usefulness of 64-slice coronary computed tomography (CCT) to rule out significant coronary artery stenosis in patients admitted in emergency departments (ED) for acute coronary syndromes (ACS) with low-to-intermediate risk score. METHODS:Patients (175) admitted for acute chest pain (ACP), unmodified electrocardiogram and first troponin measurement within normal ranges were included. A second troponin measurement and a 64-slice CCT within 24 h were performed. Major adverse cardiac events (MACE) were recorded during follow-up (6 months ± 2). RESULTS:64-slice CCT was either normal or showed non-significant coronary stenosis in the majority of patients (78%). 64-slice CCT depicted significant stenosis (>50% diameter) in 22% of patient whereas initial clinical and biological evaluation was reassuring. For negative CCTs, elevated troponin at second measurement did not modify the strategy or treatment of patients. No MACEs were noted during follow up. In 12% of patients CCT identified unsuspected non-coronary abnormalities. CONCLUSION:Our study confirms 64-slice CCT utility to rule out significant coronary artery stenosis in 8/10 patients admitted in ED with ACP or ACS with low-to-intermediate risk score. Early discharge with a negative 64-slice CCT is associated with very low risk of cardiac events at 6 months. KEY POINTS:• 64-slice coronary computed tomography (CCT) offers a critical role in acute chest pain. • 64-slice CCT allows differentiation between significant and non-significant coronary artery stenosis. • Normal 64-slice CCT allows rapid discharge of patients with ACP. • 64-slice CCT helps make appropriate therapeutic decision in patients with ACP.

journal_name

Eur Radiol

journal_title

European radiology

authors

Christiaens L,Duchat F,Boudiaf M,Tasu JP,Fargeaudou Y,Ledref O,Soyer P,Sirol M

doi

10.1007/s00330-011-2354-5

subject

Has Abstract

pub_date

2012-05-01 00:00:00

pages

1050-8

issue

eissn

0938-7994

issn

1432-1084

journal_volume

pub_type

杂志文章,多中心研究

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Impact of 64-slice coronary CT on the management of patients presenting with acute chest pain: results of a prospective two-centre study.