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Cardiac imaging and non-invasive testing
64-Slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome
  1. Willem B Meijboom1,
  2. Nico R Mollet1,
  3. Carlos A Van Mieghem1,
  4. Annick C Weustink1,
  5. Francesca Pugliese1,
  6. Niels van Pelt1,
  7. Filippo Cademartiri2,
  8. Eleni Vourvouri1,
  9. Peter de Jaegere1,
  10. Gabriel P Krestin2,
  11. Pim J de Feyter1
  1. 1
    Department of Cardiology, Thoraxcenter, and Radiology, Rotterdam, The Netherlands
  2. 2
    Department of Radiology, Rotterdam, The Netherlands
  1. Dr P J de Feyter, Department of Cardiology and Radiology, Thoraxcenter, Room Ba 589, Erasmus MC, Dr Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; p.j.defeyter{at}erasmusmc.nl

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.

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Footnotes

  • Competing interests: None.

  • Abbreviations:
    ACS
    acute coronary syndrome
    CABG
    coronary artery bypass graft
    CAD
    coronary artery disease
    CCA
    conventional coronary angiography
    CTCA
    CT coronary angiography
    PCI
    percutaneous coronary intervention
    QCA
    quantitative coronary angiography

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