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

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

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