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64-slice Computed Tomography Coronary Angiography in Patients with Non-ST Elevation Acute Coronary Syndrome
  1. Willem B Meijboom (w.b.meijboom{at}erasmusmc.nl)
  1. Erasmus University Medical Center, Netherlands
    1. Nico R Mollet (n.r.mollet{at}erasmusmc.nl)
    1. Erasmus University Medical Center, Netherlands
      1. Carlos A van Mieghem (c.vanmieghem{at}erasmusmc.nl)
      1. Erasmus University Medical Center, Netherlands
        1. Annick C Weustink (a.weustink{at}erasmusmc.nl)
        1. Erasmus University Medical Center, Netherlands
          1. Francesca Pugliese (f.pugliese{at}erasmusmc.nl)
          1. Erasmus University Medical Center, Netherlands
            1. Niels van Pelt (n.vanpelt{at}erasmusmc.nl)
            1. Erasmus University Medical Center, Netherlands
              1. Filippo Cademartiri (f.cademartiri{at}erasmusmc.nl)
              1. Erasmus University Medical Center, Netherlands
                1. Eleni Vourvouri (e.vourvouri{at}erasmusmc.nl)
                1. Erasmus University Medical Center, Netherlands
                  1. Peter de Jaegere (p.dejaegere{at}erasmusmc.nl)
                  1. Erasmus University Medical Center, Netherlands
                    1. Gabriel P Krestin (g.p.krestin{at}erasmusmc.nl)
                    1. Erasmus University Medical Center, Netherlands
                      1. Pim J de Feyter (p.j.defeyter{at}erasmusmc.nl)
                      1. Erasmus University Medical Center, Netherlands

                        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.

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

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