64-slice Computed Tomography Coronary Angiography in Patients with Non-ST Elevation Acute Coronary Syndrome

Willem B Meijboom ¹, Nico R Mollet ¹, Carlos A van Mieghem ¹, Annick C Weustink ¹, Francesca Pugliese ¹, Niels van Pelt ¹, Filippo Cademartiri ¹, Eleni Vourvouri ¹, Peter de Jaegere ¹, Gabriel P Krestin ¹ and Pim J de Feyter ^1*

¹ Erasmus University Medical Center, Netherlands

^* To whom correspondence should be addressed. E-mail: p.j.defeyter{at}erasmusmc.nl.

Accepted 13 February 2007

Abstract

Objectives A high diagnostic accuracy of 64-slice CT coronary angiography in selected patients with stable angina pectoris has been reported, but only scant information is available in patients with non-ST elevation acute coronary syndrome. We studied the diagnostic performance of 64-slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome.

Patients and methods 64-slice CT coronary angiography was performed in 104 patients (mean age 59 ± 9 years) with non ST elevation acute coronary syndrome. Two independent, blinded observers assessed all coronary arteries for stenosis, using conventional quantitative angiography as a reference. Coronary lesions with 50 percent luminal narrowing were classified as significant.

Results Conventional coronary angiography demonstrated the absence of significant disease in 15% (16/104), 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-patients analysis was 100% (88/88; 95% CI, 95-100), specificity 75% (12/16; 95% CI, 47-92) and positive and negative predictive values were 96% (88/92; 95% CI, 89-99) and 100% (12/12; 95% CI, 70-100).

Conclusion 64-slice CT coronary angiography 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 acute coronary syndrome.

Keywords: Coronary artery disease, acute coronary syndrome, computed tomography coronary angiography, non-ST elevation myocardial infarction, unstable angina pectoris

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

CT angiography: front line for acute coronary syndromes now?

Sujith K Seneviratne, Fabian Bamberg, and Udo Hoffmann
Heart 2007 93: 1325-1326. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

• Chiou, K-R, Huang, W-C, Peng, N-J, Huang, Y-L, Hsiao, S-H, Chen, K-H, Wu, M-T (2009). Dual-phase multi-detector computed tomography assesses jeopardised and infarcted myocardium subtending infarct-related artery early after acute myocardial infarction. Heart 95: 1495-1501 [Abstract] [Full Text]  
• Gibbons, R. J., Araoz, P. A., Williamson, E. E. (2009). The year in cardiac imaging.. J Am Coll Cardiol 53: 54-70 [Full Text]  
• Bluemke, D. A., Achenbach, S., Budoff, M., Gerber, T. C., Gersh, B., Hillis, L. D., Hundley, W. G., Manning, W. J., Printz, B. F., Stuber, M., Woodard, P. K. (2008). Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young. Circulation 118: 586-606 [Full Text]  
• Henneman, M. M., Schuijf, J. D., Pundziute, G., van Werkhoven, J. M., van der Wall, E. E., Jukema, J. W., Bax, J. J. (2008). Noninvasive evaluation with multislice computed tomography in suspected acute coronary syndrome plaque morphology on multislice computed tomography versus coronary calcium score.. J Am Coll Cardiol 52: 216-222 [Abstract] [Full Text]  
• Roberts, W T, Bax, J J, Davies, L C (2008). Cardiac CT and CT coronary angiography: technology and application. Heart 94: 781-792 [Abstract] [Full Text]  
• Schroeder, S., Achenbach, S., Bengel, F., Burgstahler, C., Cademartiri, F., de Feyter, P., George, R., Kaufmann, P., Kopp, A. F., Knuuti, J., Ropers, D., Schuijf, J., Tops, L. F., Bax, J. J. (2008). Cardiac computed tomography: indications, applications, limitations, and training requirements: Report of a Writing Group deployed by the Working Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. Eur Heart J 29: 531-556 [Abstract] [Full Text]  
• Seneviratne, S. K, Bamberg, F., Hoffmann, U. (2007). CT angiography: front line for acute coronary syndromes now?. Heart 93: 1325-1326 [Abstract] [Full Text]