64-Slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome. Issue 11 (7th March 2007)

• Record Type: Journal Article
• Authors: Meijboom, Willem B; Mollet, Nico R; Van Mieghem, Carlos A; Weustink, Annick C; Pugliese, Francesca; van Pelt, Niels; Cademartiri, Filippo; Vourvouri, Eleni; de Jaegere, Peter; Krestin, Gabriel P; de Feyter, Pim J
• Is Part Of: Heart. Volume 93:Issue 11(2007)
• Page Start: 1386
• Page End: 1392
• Publication Date: 2007-03-07
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2006.112771
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: A high diagnostic accuracy of 64-slice CT coronary angiography (CTCA) has been reported in selected patients with stable angina pectoris, but only scant information is available in patients with non-ST elevation acute coronary syndrome (ACS). Objectives: To study the diagnostic performance of 64-slice CTCA in patients with non-ST elevation ACS. Patients and methods: 64-slice CTCA was performed in 104 patients (mean (SD) age 59 (9) years) with non-ST elevation ACS. Two independent, blinded observers assessed all coronary arteries for stenosis, using conventional quantitative angiography as a reference. Coronary lesions with ⩾50% luminal narrowing were classified as significant. Results: Conventional coronary angiography demonstrated the absence of significant disease in 15% (16/104) of patients, and the presence of single-vessel disease in 40% (42/104) and multivessel disease in 44% (46/104) of patients. Sensitivity for detecting significant coronary stenoses on a patient-by-patient analysis was 100% (88/88; 95% CI 95 to 100), specificity 75% (12/16; 95% CI 47 to 92), and positive and negative predictive values were 96% (88/92; 95% CI 89 to 99) and 100% (12/12; 95% CI 70 to 100), respectively. Conclusion: 64-slice CTCA has a high sensitivity to detect significant coronary stenoses, and is reliable to exclude the presence of significant coronary artery disease in patients who present with a non-ST elevation ACS.